Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 1, January, p. 63–70

doi: 10.17219/acem/111808

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Cardiovascular risk factors and the concentration of asymmetric dimethylarginine

Paweł Gać1,2,A,D,F, Małgorzata Poręba3,C,D,E,F, Marta Jurdziak1,B,C,D,F, Ewa Trzmielewska1,B,E,F, Katarzyna Gocławska1,B,E,F, Arkadiusz Derkacz1,E,F, Grzegorz Mazur1,E,F, Andrzej Szuba4,5,A,E,F, Rafał Poręba1,A,C,E,F

1 Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Poland

2 Department of Hygiene, Wroclaw Medical University, Poland

3 Department of Pathophysiology, Wroclaw Medical University, Poland

4 Department of Internal Medicine, 4th Military Hospital, Wrocław, Poland

5 Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Poland

Abstract

Background. The most commonly recognized cardiovascular risk factors (CVRF) include smoking cigarettes, manifestation of arterial hypertension (AH), hypercholesterolemia, hypertriglyceridemia, manifestation of type 2 diabetes mellitus (DM), and the presence of overweight or obesity. In recent years, investigations have documented the significance of asymmetric dimethylarginine concentration (ADMA) in the pathogenesis of diseases affecting the cardiovascular system.
Objectives. To evaluate the relationship between the number of CVRF and blood ADMA concentration.
Material and Methods. The study was conducted on a sample of 138 individuals (mean age 54.90 ±10.38 years). Among the participants, we distniguished subgroups with no CVRF (group A, n = 21), with 1–2 CVRF (group B, n = 53), with 3–4 CVRF (group C, n = 55), and with 5–6 CVRF (group D, n = 9). Plasma concentrations of arginine and of endogenous methylarginines were estimated.
Results. Plasma ADMA concentrations proved to be significantly higher in groups B, C and D than those in group A. Regression analysis allowed us to demonstrate that in the studied population of patients, manifestation of type 2 DM, followed by AH and hypercholesterolemia, were linked to the highest probability of elevated plasma ADMA concentration.
Conclusion. Higher concentration of ADMA in the blood may be a marker for higher cardiovascular risk, especially associated with hypertension, type 2 DM and hypercholesterolemia.

Key words

type 2 diabetes mellitus, arterial hypertension, cardiovascular risk factors, endogenous methylarginines, asymmetric dimethylarginine

References (29)

  1. Yusuf S, Hawken S, Ounpuu S, et al; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet. 2004;364(9438):937–952.
  2. WHO. Global Health Observatory (GHO) data. http://www.who.int/gho/. Accessed June 12, 2017.
  3. Pająk A, Wiercińska E, Polakowska M, et al. Prevalence of dyslipidemia in men and women between the ages of 20–74 in Poland. Results of the WOBASZ program [in Polish]. Kardiol Pol. 2005;63(6 Suppl 4):S620–S625.
  4. Vallance P, Leiper J. Cardiovascular biology of the asymmetric dim­ethylarginine: Dimethylarginine dimethylaminohydrolase pathway. Arterio­scler Thromb Vasc Biol. 2004;24(6):1023–1030.
  5. Böger RH, Zoccali C. ADMA: A novel risk factor that explains excess cardiovascular event rate in patients with end-stage renal disease. Atheroscler Suppl. 2003;4(4):23–28.
  6. Böger RH. The emerging role of asymmetric dimethylarginine as a novel cardiovascular risk factor. Cardiovasc Res. 2003;59(4):824–833.
  7. Böger RH. Asymmetric dimethylarginine (ADMA) and cardiovascular disease: Insights from prospective clinical trials. Vasc Med. 2005;10(Suppl 1):S19–S25.
  8. Böger RH. Asymmetric dimethylarginine (ADMA): A novel risk marker in cardiovascular medicine and beyond. Ann Med. 2006;38(2):126–136.
  9. Böger RH, Bode-Böger SM, Szuba A, et al. Asymmetric dimethylarginine (ADMA): A novel risk factor for endothelial dysfunction: Its role in hypercholesterolemia. Circulation. 1998;98(18):1842–1847.
  10. Tang WH, Wang Z, Cho L, Brennan DM, Hazen SL. Diminished global arginine bioavailability and increased arginine catabolism as metabolic profile of increased cardiovascular risk. J Am Coll Cardiol. 2009;53(22):2061–2067.
  11. Wang J, Sim AS, Wang XL, Salonikas C, Naidoo D, Wilcken DE. Relations between plasma asymmetric dimethylarginine (ADMA) and risk factors for coronary disease. Atherosclerosis. 2006;184(2):383–388.
  12. Hov GG, Sagen E, Hatlen G, Bigonah A, Åsberg A, Aasarød K. Arginine/asymmetric dimethylarginine ratio and cardiovascular risk factors in patients with predialytic chronic kidney disease. Clin Biochem. 2011;44(8–9):642–646.
  13. Tayeh O, Fahmi A, Islam M, Saied M. Asymmetric dimethylarginine as a prognostic marker for cardiovascular complications in hypertensive patients. Egyptian Heart J. 2011;63(2):117–124.
  14. Fliser D, Kronenberg F, Kielstein JT, et al. Asymmetric dimethylarginine and progression of chronic kidney disease: The mild to moderate kidney disease study. J Am Soc Nephrol. 2005;16(8):2456–2461.
  15. Schulze F, Maas R, Freese R, Schwedhelm E, Silberhorn E, Böger RH. Determination of a reference value for N(G), N(G)-dimethyl-L-arginine in 500 subjects. Eur J Clin Invest. 2005;35(10):622–626.
  16. Bakris GL, Williams M, Dworkin L, et al. Preserving renal function in adults with hypertension and diabetes: A consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis. 2000;36(3):646–661.
  17. Dayoub H, Achan V, Adimoolam S, et al. Dimethylarginine dimethyl-aminohydrolase regulates nitric oxide synthesis: Genetic and physiological evidence. Circulation. 2003;108(24):3042–3047.
  18. Poręba R, Gać P, Poręba M, et al. Left ventricular diastolic dysfunction and plasma asymmetric dimethylarginine concentration in persons with essential hypertension. Arch Med Sci. 2015;11(3):521–529.
  19. Achan V, Broadhead M, Malaki M, et al. Asymmetric dimethylarginine causes hypertension and cardiac dysfunction in humans and is actively metabolized by dimethylarginine dimethylaminohydrolase. Arterioscler Thromb Vasc Biol. 2003;23(8):1455–1459.
  20. Stühlinger MC, Abbasi F, Chu JW, et al. Relationship between insulin resistance and an endogenous nitric oxide synthase inhibitor. JAMA. 2002;287(11):1420–1426.
  21. Ercan M, Firtina S, Konukoglu D. Comparison of plasma viscosity as a marker of endothelial dysfunction with nitric oxide and asymmetric dimethylarginine in subjects with dyslipidemia. Clin ­Hemorheol Microcirc. 2014;57(4):315–323.
  22. Abbasi F, Asagmi T, Cooke JP, et al. Plasma concentrations of asymmetric dimethylarginine are increased in patients with type 2 diabetes mellitus. Am J Cardiol. 2001;88(10):1201–1203.
  23. Tarnow L, Hovind P, Teerlink T, Stehouwer CD, Parving HH. Elevated plasma asymmetric dimethylarginine as a marker of cardiovascular morbidity in early diabetic nephropathy in type 1 diabetes. ­Diabetes Care. 2004;27(3):765–769.
  24. Kanazawa I, Yano S, Notsu Y, Yamaguchi T, Nabika T, Sugimoto T. Asymmetric dimethylarginine as a risk factor for cardiovascular disease in Japanese patients with type 2 diabetes mellitus. Clin Endocrinol (Oxf). 2011;74(4):467–472.
  25. Konya H, Miuchi M, Satani K, et al. Asymmetric dimethylarginine, a biomarker of cardiovascular complications in diabetes mellitus. World J Exp Med. 2015;5(2):110–119.
  26. Krzyzanowska K, Mittermayer F, Wolzt M, Schernthaner G. Asymmetric dim­ethylarginine predicts cardiovascular events in patients with type 2 diabetes. Diabetes Care. 2007;30(7):1834–1839.
  27. Anderssohn M, McLachlan S, Lüneburg N, et al. Genetic and environmental determinants of dimethylarginines and association with cardiovascular disease in patients with type 2 diabetes. Diabetes Care. 2014;37(3):846–854.
  28. Böger RH, Sullivan LM, Schwedhelm E, et al. Plasma asymmetric dim­ethylarginine and incidence of cardiovascular disease and death in the community. Circulation. 2009;119(12):1592–1600.
  29. Pitocco D, Zaccardi F, Di Stasio E, et al. Role of asymmetric-dimethyl-L-arginine (ADMA) and nitrite/nitrate (NOx) in the pathogenesis of oxidative stress in female subjects with uncomplicated type 1 diabetes mellitus. Diabetes Res Clin Pract. 2009;86(3):173–176.