Department of Gastroenterology, Gulhane Medical School, Ankara, Turkey.
Diabetes Res Clin Pract. 2012 Apr;96(1):47-52. doi: 10.1016/j.diabres.2011.11.022. Epub 2011 Dec 19.
Non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease. Asymmetric dimethylarginine (ADMA) is a novel marker of endothelial dysfunction and atherosclerosis. We aimed to investigate circulating ADMA concentrations in biopsy proven NAFLD and also to search its association with carotid atherosclerosis.
Sixty-seven nondiabetic and normotensive patients with NAFLD and 35 healthy controls were enrolled. Plasma ADMA was measured along with glucose, lipids and insulin levels. Insulin resistance (IR) was assessed by homeostasis model assessment-estimated insulin resistance (HOMA-IR) method. Carotid atherosclerosis was evaluated by carotid artery intima-media thickness (CIMT) using carotid ultrasonography.
ADMA levels and CIMT measurements were significantly higher in NAFLD group than the controls. However, the difference regarding the CIMT disappeared when the findings were adjusted according to the metabolic parameters and insulin sensitivity. In contrast, the difference for ADMA remained significant between two groups. No significant association was found between ADMA, CIMT and histopathological findings.
Plasma ADMA levels are increased in subjects with NAFLD. This increase seems to be independent from traditional cardiovascular risk factors, insulin resistance and liver histology. Circulating ADMA may be an earlier marker of vascular damage with respect to CIMT in subjects with NAFLD.
非酒精性脂肪性肝病（NAFLD）与心血管疾病有关。不对称二甲基精氨酸（ADMA）是内皮功能障碍和动脉粥样硬化的新型标志物。我们旨在研究活检证实的 NAFLD 患者的循环 ADMA 浓度，并探讨其与颈动脉粥样硬化的关系。
纳入 67 名非糖尿病和血压正常的 NAFLD 患者和 35 名健康对照者。测定血浆 ADMA 水平及血糖、血脂和胰岛素水平。采用稳态模型评估-胰岛素抵抗（HOMA-IR）法评估胰岛素抵抗（IR）。采用颈动脉超声检查颈动脉内膜中层厚度（CIMT）评估颈动脉粥样硬化。
NAFLD 组的 ADMA 水平和 CIMT 测量值明显高于对照组。然而，当根据代谢参数和胰岛素敏感性调整这些发现时，CIMT 的差异消失了。相比之下，两组之间 ADMA 的差异仍然显著。ADMA、CIMT 与组织病理学发现之间无显著相关性。
NAFLD 患者的血浆 ADMA 水平升高。这种增加似乎独立于传统心血管危险因素、胰岛素抵抗和肝脏组织学。与 CIMT 相比，循环 ADMA 可能是 NAFLD 患者血管损伤的早期标志物。
