Richir Milan C, Bouwman Roderick H, Teerlink Tom, Siroen Michiel P C, de Vries Theo P G M, van Leeuwen Paul A M
Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
JPEN J Parenter Enteral Nutr. 2008 Nov-Dec;32(6):613-21. doi: 10.1177/0148607108321702.
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS), the enzyme which converts the amino acid arginine into nitric oxide (NO). ADMA has been identified as an important risk factor for cardiovascular diseases. Besides the role of ADMA in cardiovascular diseases, it also seems to be an important determinant in the development of critical illness, (multiple) organ failure, and the hepatorenal syndrome. ADMA is eliminated from the body by urinary excretion, but it is mainly metabolized by the dimethylarginine dimethylaminohydrolase (DDAH) enzymes that convert ADMA into citrulline and dimethylamine. DDAH is highly expressed in the liver, which makes the liver a key organ in the regulation of the plasma ADMA concentration. The prominent role of the liver in the elimination of ADMA and the consequences of impaired hepatic function on ADMA levels will be discussed in this article.
不对称二甲基精氨酸（ADMA）是一氧化氮合酶（NOS）的内源性抑制剂，该酶可将氨基酸精氨酸转化为一氧化氮（NO）。ADMA已被确定为心血管疾病的重要危险因素。除了ADMA在心血管疾病中的作用外，它似乎也是危重病、（多）器官衰竭和肝肾综合征发生发展的重要决定因素。ADMA通过尿液排泄从体内清除，但它主要由二甲基精氨酸二甲胺水解酶（DDAH）代谢，该酶将ADMA转化为瓜氨酸和二甲胺。DDAH在肝脏中高度表达，这使得肝脏成为调节血浆ADMA浓度的关键器官。本文将讨论肝脏在ADMA清除中的重要作用以及肝功能受损对ADMA水平的影响。
