Department of Biochemistry, Ege University, Faculty of Medicine, Izmir, Turkey.
Clin Biochem. 2012 Nov;45(16-17):1325-30. doi: 10.1016/j.clinbiochem.2012.06.024. Epub 2012 Jun 27.
Elevated homocysteine (Hcy) concentrations have been shown to be a risk factor for atherosclerotic vascular disease and thrombosis. Increased asymmetric dimethylarginine (ADMA) levels have been implicated in the pathogenesis of numerous conditions affecting the cardiovascular system. In this study, the influence of cardiovascular risk factors and other variables on Hcy and ADMA relationship in patients with coronary artery disease (CAD) was investigated.
Seventy-five patients with CAD were divided into three tertiles according to their Hcy levels. The effect of age, gender, blood pressure, lipid profile, renal function, and the presence of diabetes, insulin resistance, heart failure, inflammation, overweight, smoking and severity of coronary atherosclerosis on Hcy and ADMA relationship was evaluated.
ADMA concentrations of patients in the middle and highest Hcy tertiles were significantly higher than the patients in the lowest tertile. When ADMA concentrations were adjusted for demographic, clinical and laboratory variables, the significant differences in ADMA concentrations between the tertiles were preserved. ADMA levels positively correlated with Hcy. Homocysteine levels positively correlated with serum creatinine and NT-proBNP concentrations and negatively correlated with glomerular filtration rates. Stepwise multiple regression analysis revealed Hcy as the unique predictor of ADMA levels.
Homocysteine concentration has an effect on ADMA levels. There is a strong correlation between Hcy and ADMA. Cardiovascular risk factors do not have an influence on this relationship.
高同型半胱氨酸（Hcy）浓度已被证明是动脉粥样硬化性血管疾病和血栓形成的危险因素。不对称二甲基精氨酸（ADMA）水平升高与影响心血管系统的多种疾病的发病机制有关。在这项研究中，研究了心血管危险因素和其他变量对冠心病（CAD）患者 Hcy 和 ADMA 关系的影响。
根据 Hcy 水平将 75 例 CAD 患者分为三组。评估年龄、性别、血压、血脂谱、肾功能以及糖尿病、胰岛素抵抗、心力衰竭、炎症、超重、吸烟和冠状动脉粥样硬化严重程度对 Hcy 和 ADMA 关系的影响。
Hcy 中值和高值 tertiles 组患者的 ADMA 浓度明显高于低值 tertiles 组。当 ADMA 浓度按人口统计学、临床和实验室变量进行调整时， tertiles 之间 ADMA 浓度的显著差异仍然存在。ADMA 水平与 Hcy 呈正相关。Hcy 水平与血清肌酐和 NT-proBNP 浓度呈正相关，与肾小球滤过率呈负相关。逐步多元回归分析显示 Hcy 是 ADMA 水平的唯一预测因子。
Hcy 浓度对 ADMA 水平有影响。Hcy 和 ADMA 之间存在很强的相关性。心血管危险因素对这种关系没有影响。
