Kiani Adnan N, Mahoney James A, Petri Michelle
Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
J Rheumatol. 2007 Jul;34(7):1502-5.
To determine the association of serum asymmetric dimethylarginine (ADMA) with clinical features, laboratory tests, treatment, cardiovascular risk factors, and subclinical atherosclerosis in patients with systemic lupus erythematosus (SLE).
Serum ADMA concentrations were determined by ELISA, using purified ADMA as a standard. Coronary calcium was measured by helical computerized tomography.
Two hundred patients with SLE participated. Patients had a mean age of 44.3 +/- 11.4 years and were 92% female, 61% Caucasian, 34% African American, 2% Asian, and 2% Hispanic; 18% had elevated ADMA levels. The mean ADMA was 0.31. Significantly higher ADMA levels were found in African Americans (p < 0.001), and were correlated with anti-dsDNA (p < 0.001), anti-Sm (p = 0.005), anti-ribonucleoprotein (p = 0.002), low C4 (p = 0.004), and high erythrocyte sedimentation rate (p < 0.001). ADMA was negatively associated with total cholesterol (p = 0.004). Elevated ADMA was associated with the presence of coronary calcium (p = 0.02).
Elevated ADMA is strongly associated with African American ethnicity, anti-dsDNA, low complement, and prednisone use, all markers of poor prognosis in SLE. It is negatively associated with hyperlipidemia, but positively associated with coronary calcium. Thus, it identifies a subset of SLE patients with normal lipid levels who are at risk for atherosclerosis.
确定系统性红斑狼疮（SLE）患者血清不对称二甲基精氨酸（ADMA）与临床特征、实验室检查、治疗、心血管危险因素及亚临床动脉粥样硬化之间的关联。
采用酶联免疫吸附测定法（ELISA），以纯化的ADMA作为标准来测定血清ADMA浓度。通过螺旋计算机断层扫描测量冠状动脉钙化情况。
200例SLE患者参与研究。患者的平均年龄为44.3±11.4岁，女性占92%，其中61%为白种人，34%为非裔美国人，2%为亚洲人，2%为西班牙裔；18%的患者ADMA水平升高。ADMA的平均值为0.31。非裔美国人的ADMA水平显著更高（p<0.001），且与抗双链DNA（p<0.001）、抗Sm（p = 0.005）、抗核糖核蛋白（p = 0.002）、低C4（p = 0.004）及高红细胞沉降率（p<0.001）相关。ADMA与总胆固醇呈负相关（p = 0.004）。ADMA升高与冠状动脉钙化的存在相关（p = 0.02）。
ADMA升高与非裔美国人种族、抗双链DNA、低补体及泼尼松使用密切相关，这些均为SLE预后不良的标志物。它与高脂血症呈负相关，但与冠状动脉钙化呈正相关。因此，它可识别出一部分血脂水平正常但有动脉粥样硬化风险的SLE患者。
