Jaźwińska-Kozuba Aleksandra, Martens-Lobenhoffer Jens, Surdacki Andrzej, Kruszelnicka Olga, Rycaj Jarosław, Godula-Stuglik Urszula, Bode-Böger Stefanie M
Almed-Elektra Medical Center, 41-710 Ruda Śląska, Poland.
Int J Mol Sci. 2012 Nov 21;13(11):15464-74. doi: 10.3390/ijms131115464.
The structural isomer of asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), is eliminated almost entirely by urinary excretion and considered a sensitive index of glomerular filtration rate (GFR). However, reports on this relationship in healthy subjects younger than 18 years of age are rare. Therefore, our aim was to investigate relations between endogenous dimethylarginines and renal function indices in healthy children and adolescents. We studied 40 subjects aged 3–18 years free of coexistent diseases or subclinical carotid atherosclerosis. A serum creatinine-derived estimated GFR (eGFR) was calculated by the revised bedside Schwartz equation. L-arginine, ADMA and SDMA were measured by liquid chromatography-tandem mass spectrometry. Mean eGFR was 122 ± 22 (SD) mL/min per 1.73 m2. Creatinine and eGFR exhibited closer correlations with the SDMA/ADMA ratio (r = 0.64, p < 0.0001; r = −0.63, p < 0.0001, respectively) than with SDMA (r = 0.31, p = 0.05; r = −0.35, p = 0.03). Neither creatinine nor eGFR correlated with ADMA or L-arginine. Adjustment for age or height only slightly attenuated the associations between the SDMA/ADMA ratio and eGFR or creatinine. Our findings suggest the superiority of the SDMA/ADMA ratio over SDMA as a renal function index in healthy children. Thus, further studies are warranted to verify our preliminary results in a larger group of subjects below 18 years of age.
不对称二甲基精氨酸（ADMA）的结构异构体——对称二甲基精氨酸（SDMA），几乎完全通过尿液排泄清除，被认为是肾小球滤过率（GFR）的敏感指标。然而，关于18岁以下健康受试者中这种关系的报道很少。因此，我们的目的是研究健康儿童和青少年体内二甲基精氨酸与肾功能指标之间的关系。我们研究了40名年龄在3至18岁之间、无并存疾病或亚临床颈动脉粥样硬化的受试者。通过修订后的床边施瓦茨方程计算血清肌酐衍生的估计GFR（eGFR）。采用液相色谱-串联质谱法测定L-精氨酸、ADMA和SDMA。平均eGFR为每1.73 m² 122±22（标准差）mL/min。肌酐和eGFR与SDMA/ADMA比值的相关性（分别为r = 0.64，p < 0.0001；r = -0.63，p < 0.0001）比与SDMA的相关性（r = 0.31，p = 0.05；r = -0.35，p = 0.03）更密切。肌酐和eGFR与ADMA或L-精氨酸均无相关性。对年龄或身高进行校正后，仅略微减弱了SDMA/ADMA比值与eGFR或肌酐之间的关联。我们的研究结果表明，在健康儿童中，SDMA/ADMA比值作为肾功能指标优于SDMA。因此，有必要进行进一步研究，以在更大的18岁以下受试者群体中验证我们的初步结果。
