YOU Ling, ZHAO Chun-xia, SHAO Jiao-mei, ZHANG Luo, WANG Dao-wen
Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Sep;38(9):798-800.
To compare plasma asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, and cystatin C levels in patients with or without coronary artery disease (CAD).
We recruited 87 CAD patients (39 with acute myocardial infarction and 48 with unstable angina pectoris) and 51 non-CAD controls. Plasma ADMA was measured by HPLC, cystatin C by particle-enhanced immunonephelometric assay (N Latex cystatin C, Dade Behring) with nephelometer (BNII, Dade Behring). CAD patients were further divided into low cystatin C group (< 1.0 mg/L, 36 cases) and high cystatin C group (> 1.0 mg/L, 51 cases).
(1) The plasma levels of ADMA [(0.47 ± 0.15) µmol/L vs. (0.37 ± 0.15) µmol/L], SDMA [(0.39 ± 0.19) µmol/L vs. (0.28 ± 0.12) µmol/L] and cystatin C [(1.16 ± 0.32) mg/L vs. (0.73 ± 0.16) mg/L] were significantly higher in CAD patients than in controls (all P < 0.05). The plasma L-Arg was significantly lower in CAD patients than in controls [(59.4 ± 19.4) µmol/L vs. (83.7 ± 19.6) µmol/L, P < 0.05]. (2) Plasma ADMA was similar in CAD patients with low cystatin C level and controls [(0.42 ± 0.12) µmol/L vs. (0.39 ± 0.15) µmol/L, P = 0.251] and Plasma ADMA was significantly higher in CAD patients with high cystatin C level than in controls [(0.50 ± 0.17) µmol/L vs. (0.39 ± 0.15) µmol/L, P < 0.05].
ADMA levels were significantly increased only in CAD patients with elevated cystatin C levels but not in CAD patients with normal renal function. The reported relationship between coronary heart disease and ADMA may not be direct, but could be secondary due to reduced renal function.
比较有无冠状动脉疾病（CAD）患者血浆中内源性一氧化氮合酶抑制剂不对称二甲基精氨酸（ADMA）和胱抑素C水平。
我们招募了87例CAD患者（39例急性心肌梗死患者和48例不稳定型心绞痛患者）以及51例非CAD对照者。采用高效液相色谱法测定血浆ADMA，用颗粒增强免疫比浊法（N Latex胱抑素C，达德拜耳公司）和比浊仪（BNII，达德拜耳公司）测定胱抑素C。CAD患者进一步分为低胱抑素C组（<1.0mg/L，36例）和高胱抑素C组（>1.0mg/L，51例）。
（1）CAD患者血浆ADMA水平[（0.47±0.15）μmol/L对（0.37±0.15）μmol/L]、SDMA水平[（0.39±0.19）μmol/L对（0.28±0.12）μmol/L]和胱抑素C水平[（1.16±0.32）mg/L对（0.73±0.16）mg/L]显著高于对照组（均P<0.05）。CAD患者血浆L-精氨酸水平显著低于对照组[（59.4±19.4）μmol/L对（83.7±19.6）μmol/L，P<0.05]。（2）低胱抑素C水平的CAD患者血浆ADMA与对照组相似[（0.42±0.12）μmol/L对（0.39±0.15）μmol/L，P=0.251]，高胱抑素C水平的CAD患者血浆ADMA显著高于对照组[（0.50±0.17）μmol/L对（0.39±0.15）μmol/L，P<0.0五]。
仅在胱抑素C水平升高的CAD患者中ADMA水平显著升高，而在肾功能正常的CAD患者中未升高。冠心病与ADMA之间报道的关系可能不是直接的，而是由于肾功能降低继发的。
