Department of Internal Medicine 1, The Center for Community-based Health Research and Education (COHRE), Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Japan.
Clin Endocrinol (Oxf). 2011 Apr;74(4):467-72. doi: 10.1111/j.1365-2265.2010.03946.x.
Although asymmetric dimethylarginine (ADMA) is known to be involved in the developing process of cardiovascular diseases (CVD), little is known about the effects of ADMA on atherosclerosis in Asian patients with diabetes, who have the racial feature of lower body mass index (BMI) and decreased capacity of insulin secretion and sensitivity.
We employed 55 Japanese patients with type 2 diabetes mellitus (mean age, 64·2 years; 56% men) in a 6-month-longitudinal study and 450 patients (mean age, 62·7 years; 56% men) in a cross-sectional study and examined the association of serum ADMA with atherosclerosis parameters [intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV)] as well as with the presence of CVD.
In the longitudinal study, multiple regression analysis showed that basal serum ADMA level had a significantly positive association with changes in IMT (β=0·35, P=0·03) independently of age, duration of diabetes, BMI, blood pressure, low-density lipoprotein and high-density lipoprotein (LDL and HDL) cholesterol, HbA(1c) , and renal function. In the cross-sectional study, the serum ADMA level was significantly and positively associated with the presence of CVD (odds ratio=7·22, 95% confidence interval 1·29-40·40, P=0·02, by logistic analysis) and with baPWV (β=0·14, P <0·01, by multiple regression analysis). In contrast, serum symmetric dimethylarginine level, a structural isomer of ADMA, was associated neither with parameters for atherosclerosis nor with the presence of CVD in both studies.
Serum ADMA is a predictor of atherosclerosis and associated with the presence of CVD in Japanese patients with type 2 diabetes mellitus.
尽管不对称二甲基精氨酸（ADMA）已知与心血管疾病（CVD）的发展过程有关，但对于亚洲糖尿病患者的动脉粥样硬化，ADMA 的作用知之甚少。这些亚洲糖尿病患者具有体重指数（BMI）较低、胰岛素分泌和敏感性降低的种族特征。
我们对 55 名日本 2 型糖尿病患者（平均年龄 64.2 岁，56%为男性）进行了 6 个月的纵向研究，并对 450 名患者（平均年龄 62.7 岁，56%为男性）进行了横断面研究，检查了血清 ADMA 与动脉粥样硬化参数[内膜-中层厚度（IMT）和肱踝脉搏波速度（baPWV）]以及 CVD 存在之间的关系。
在纵向研究中，多元回归分析显示，基础血清 ADMA 水平与 IMT 的变化呈显著正相关（β=0.35，P=0.03），独立于年龄、糖尿病持续时间、BMI、血压、低密度脂蛋白和高密度脂蛋白（LDL 和 HDL）胆固醇、HbA（1c）和肾功能。在横断面研究中，血清 ADMA 水平与 CVD 的存在呈显著正相关（优势比=7.22，95%置信区间 1.29-40.40，P=0.02，逻辑分析），与 baPWV 呈显著正相关（β=0.14，P<0.01，多元回归分析）。相反，血清对称二甲基精氨酸水平，ADMA 的结构异构体，在两项研究中均与动脉粥样硬化参数或 CVD 的存在均无关。
血清 ADMA 是日本 2 型糖尿病患者动脉粥样硬化的预测因子，与 CVD 的存在相关。
