Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 5, May, p. 693–698

doi: 10.17219/acem/78360

Publication type: original article

Language: English

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Serum asymmetric dimethylarginine and nitric oxide levels in Turkish patients with acute ischemic stroke

Mujgan Ercan1,A,D, Semra Mungan2,B,E,F, Işıl Güzel2,D,E,F, Huseyin Tugrul Celik3,E,F, Ceylan Bal4,B,F, Sedat Abusoglu5,C,F, Deniz Akbulut6,D,F, Esra Firat Oguz7,A,F, Fatma Meric Yilmaz8,C,F

1 Department of Biochemistry, Aydın Public Health Laboratory, Turkey

2 Department of Neurology, Ankara Numune Training and Education Hospital, Turkey

3 Department of Biochemistry, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey

4 Department of Biochemistry, 4th Ankara Occupational Diseases Hospital, Turkey

5 Department of Biochemistry, Faculty of Medicine, Selçuk University, Konya, Turkey

6 Çukurova Dr. Aşkım Tüfekçi Hospital, Adana, Turkey

7 Department of Biochemistry, Ankara Numune Training and Education Hospital, Turkey

8 Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey


Background. Nitric oxide synthase (NOS) is present in the brain and cerebral arteries and it enables the synthesis of nitric oxide (NO), which plays a critical role in brain perfusion. Asymmetrical dimethylarginine (ADMA) is an endogenous NOS inhibitor.
Objectives. The aim of this study was to evaluate serum ADMA levels, which are an indicator of endothelial dysfunction of the renal functions in patients with acute ischemic stroke, and to determine whether there is a possible correlation between ADMA and NO levels and the l-arginine-to-ADMA ratio.
Material and Methods. Fifty-two patients (22 male and 30 female; mean age: 75.2 ±10.1 years) with a diagnosis of acute ischemic stroke in the first 24 h post-stroke and 48 healthy individuals (controls; 13 male and 35 female; mean age: 60.1 ±7.92 years) were included in this study. The risk factors recorded and evaluated were age and gender of the patients, serum lipid levels, serum ADMA levels, nitrate-to-nitrite ratios, l-arginine, l-arginine-to-ADMA ratios, sedimentation rate, C-reactive protein (CRP), urea and creatinine levels, and glomerular filtration ratio (eGFR).
Results. The mean serum ADMA level was 0.48 ±0.23 μM for the patients and 0.36 ±0.18 μM for the controls. The mean NO level was 2.78 ±0.59 μM for the patient group and 4.49 ±2.84 μM for the controls. The ADMA levels for the patient group were significantly higher than for the control group (p = 0.011); the NO levels for the patients were significantly lower than for the controls (p < 0.001). The logistic regression method demonstrated that ADMA and NO levels may be independent risk factors for the patient group, and the receiver operating characteristic (ROC) curve analysis showed that both of these variables were discriminative risk factors.
Conclusion. An increased serum level of the NOS inhibitor ADMA was found to be a possible independent risk factor for ischemic stroke.

Key words

nitric oxide, asymmetrical dimethylarginine, asymmetrical dimethylarginine/arginine levels, arginine, acute ischemic stroke

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