Metabolic Laboratory, Department of Clinical Chemistry, VU University Medical Center, De Boelelaan 1117, 1007 MB Amsterdam, The Netherlands.
J Hypertens. 2013 Jun;31(6):1114-23. doi: 10.1097/HJH.0b013e32836037fb.
Production of nitric oxide by the vascular endothelium is crucial for the maintenance of vascular tone, an important determinant of blood pressure. L-Arginine and its homolog L-homoarginine are competitive substrates of nitric oxide synthase (NOS), whereas asymmetric dimethylarginine (ADMA) is a NOS inhibitor. We evaluated the relationships between physiological levels of these amino acids and blood pressure.
The relationship between blood pressure and plasma levels of L-arginine, L-homoarginine, and ADMA was studied in participants of the Hoorn study, a population-based cohort study of elderly participants (n = 746, aged 50-87, 49.5% men).
In linear regression models adjusted for age, sex, L-arginine, and ADMA, a positive association was observed between L-homoarginine and SBP [3.90 mmHg per 1-SD increment of L-homoarginine (95% confidence interval, CI 2.28-5.52)] and DBP [1.83 (0.95-2.72)]. In these models, L-arginine was not significantly associated with SBP [-0.68 mmHg per 1-SD increment of L-arginine (95% CI -2.23 to 0.88)], but a significant inverse association with DBP was observed [-1.17 (-2.02 to -0.32)]. These associations were slightly attenuated after further adjustment for glucose or BMI, but not after adjustment for other cardiovascular risk factors (lipids, smoking, inflammation markers, microalbuminuria, prior cardiovascular disease, and antihypertensive medication). ADMA was not significantly associated with either SBP or DBP.
In elderly participants, plasma levels of L-homoarginine and L-arginine are independently associated with clinically relevant differences in blood pressure in an antagonistic fashion.
血管内皮细胞产生的一氧化氮对于维持血管张力至关重要，而血管张力是血压的一个重要决定因素。L-精氨酸及其同系物 L-高半胱氨酸是一氧化氮合酶（NOS）的竞争性底物，而不对称二甲基精氨酸（ADMA）是 NOS 的抑制剂。我们评估了这些氨基酸的生理水平与血压之间的关系。
我们在 Hoorn 研究的参与者中研究了血压与血浆 L-精氨酸、L-高半胱氨酸和 ADMA 水平之间的关系，该研究是一项针对老年参与者的基于人群的队列研究（n=746，年龄 50-87 岁，49.5%为男性）。
在调整了年龄、性别、L-精氨酸和 ADMA 的线性回归模型中，观察到 L-高半胱氨酸与 SBP 呈正相关[每增加 1-SD 的 L-高半胱氨酸，SBP 增加 3.90mmHg（95%置信区间，2.28-5.52）]和 DBP[1.83（0.95-2.72）]。在这些模型中，L-精氨酸与 SBP 无显著相关性[-0.68mmHg 每增加 1-SD 的 L-精氨酸（95%置信区间-2.23 至 0.88）]，但与 DBP 呈显著负相关[-1.17（-2.02 至-0.32）]。这些关联在进一步调整血糖或 BMI 后略有减弱，但在调整其他心血管危险因素（脂质、吸烟、炎症标志物、微量白蛋白尿、既往心血管疾病和降压药物）后则没有减弱。ADMA 与 SBP 或 DBP 均无显著相关性。
在老年参与者中，血浆 L-高半胱氨酸和 L-精氨酸水平与血压的临床相关差异独立相关，呈拮抗方式。
