Bultink I E M, Teerlink T, Heijst J A, Dijkmans B A C, Voskuyl A E
Department of Rheumatology, VU University Medical Centre, Postbus 7057, 1007 MB, Amsterdam, The Netherlands.
Ann Rheum Dis. 2005 Sep;64(9):1362-5. doi: 10.1136/ard.2005.036137.
Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide inhibitor and a new independent risk factor for endothelial dysfunction and cardiovascular disease.
To investigate the relationship between plasma ADMA levels and cardiovascular events (CVEs) and disease characteristics in patients with systemic lupus erythematosus (SLE).
Demographic and clinical data were collected and plasma ADMA levels were measured in 107 patients with SLE. A modified organ damage index was calculated as defined by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), excluding CVE as an item.
Cardiovascular disease, defined as > or =1 previous arterial CVE, was recorded in 16/107 (15%) patients with SLE and increased across tertiles of ADMA levels (p = 0.023 for trend). Mean plasma ADMA levels were significantly higher in patients with SLE with a history of CVEs than in patients without a CVE history (p = 0.018). In multiple regression analysis a high SLEDAI score, high modified SDI, high titre of anti-dsDNA antibodies, and low serum HDL were significantly associated with high plasma ADMA levels.
In patients with SLE, plasma ADMA levels are significantly associated with CVEs, measures of disease activity, and organ damage, independently of an unfavourable lipid profile.
不对称二甲基精氨酸（ADMA）是一种内源性一氧化氮抑制剂，也是内皮功能障碍和心血管疾病的一个新的独立危险因素。
研究系统性红斑狼疮（SLE）患者血浆ADMA水平与心血管事件（CVE）及疾病特征之间的关系。
收集107例SLE患者的人口统计学和临床资料，并检测其血浆ADMA水平。按照系统性红斑狼疮国际协作临床中心/美国风湿病学会损伤指数（SDI）的定义计算改良器官损伤指数，但不将CVE作为一项纳入。
107例SLE患者中有16例（占15%）有心血管疾病，定义为既往有≥1次动脉CVE，且ADMA水平三分位数升高时心血管疾病发生率增加（趋势p = 0.023）。有CVE病史的SLE患者的平均血浆ADMA水平显著高于无CVE病史的患者（p = 0.018）。在多元回归分析中，高SLEDAI评分、高改良SDI、高滴度抗双链DNA抗体和低血清高密度脂蛋白与高血浆ADMA水平显著相关。
在SLE患者中，血浆ADMA水平与CVE、疾病活动度指标和器官损伤显著相关，与不良血脂谱无关。
