Aysun Toraman, Belda Dursun, Simin Rota, Baki Yagci, Turkey
Introduction: Plasma asymmetric dimethylarginine (ADMA) is a potential risk factor for cardiovascular diseases. We performed a study toassess the relationship between ADMA and premature atherosclerosis as determined by carotid intima-media thickness (CIMT) and coronary artery calcification score (CACS) in uremic patients.
Methods: The study was performed on 38 predialysis and 39 dialysis patients and 46 controls. Plasma ADMA were determined. Carotid IMT was measured by ultrasonography. CACS was measured by multislice computed tomography.
Results: CIMT values were higher in dialysis (0.78+-0.16 mm) and predialysis patients (0.74+_0.20 mm) than control group (0.56+_0.11 mm) ( p<0.001). CACS were found to be higher in dialysis (701.97+_1437.03) and predialysis patients (64.79+_143.02) than controls (28.95+_158.65) (p=0.003. p<0.001 respectively). Similarly, plasma ADMA levels were higher in dialysis (1.44+_0.58 Umol/L) and predialysis patients (1.04+_0.43 Umol/L) than controls(0.69+_0.56 Umol/L) (p<0.001).
In the analysis of total cohort carotid IMT showed positive correlation with age, creatinine, Ca-P product, PTH, ADMA, nitrate and CACS; and negative correlation with HDL cholesterol. CACS showed positive correlations with age, ALP, PTH, ADMA, nitrite, carotid IMT, and showed negative correlation with HDL cholesterol. ADMA showed positive correlations with serum creatinine, Ca-P product, ALP, PTH, TG, carotid IMT, and showed negative correlation with MDRD-GFR and HDL cholesterol levels. ADMA and CACS showed positive correlations with duration of dialysis and duration of renal failure.
Conclusions: Because of having significant correlations with calcification parameters, dyslipidemia, inflammation and malnutrition; ADMA levels can be used as as a determinant for atherosclerotic process of cardiovascular disease in chronic renal failure.