Xuan Chao, Tian Qing-Wu, Li Hui, Zhang Bei-Bei, He Guo-Wei, Lun Li-Min
Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, China.
Department of Molecular Microbiology, Oslo University Hospital, Norway.
Eur J Prev Cardiol. 2016 Mar;23(5):502-10. doi: 10.1177/2047487315586094. Epub 2015 May 8.
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial nitric oxide synthase by competing with L-arginine. As a result, the expression of nitric oxide decreases and endothelial dysfunction occurs. Studies have evaluated the association between the serum ADMA level and risk of coronary artery disease. However, conflicting results have been obtained.
Pubmed, Web of Science, Embase, Ovid, Cochrane databases were searched to identify eligible studies published in English until December 2014. Association was assessed on the basis of weighted mean differences (WMD) with 95% confidence intervals (CIs). Publication bias was analysed using Begg's and Egger's tests. Sensitivity analysis was performed to evaluate result stability.
A total of 16 case-control studies with 2939 patients and 1774 controls were included in the meta-analysis. Pooled result indicated that patients with coronary artery disease yielded a higher ADMA level than healthy controls (WMD: 0.248, 95% CI: 0.156-0.340; p = 1.16 e-7). Sensitivity analysis suggested that our meta-analysis result was stable. Subgroup analysis found a similar pattern in patients with myocardial infarction (WMD: 0.397, 95% CI: 0.112-0.683; p = 0.0106), stable angina pectoris (WMD: 0.197, 95% CI: 0.031-0.364; p = 0.02) and unstable angina pectoris (WMD: 0.857, 95% CI: 0.293-1.420; p = 0.003).
Meta-analysis results indicated that an increased ADMA level is associated with an increased risk of coronary artery disease.
不对称二甲基精氨酸（ADMA）是一种内源性内皮型一氧化氮合酶抑制剂，通过与L-精氨酸竞争发挥作用。因此，一氧化氮的表达降低，内皮功能障碍发生。已有研究评估了血清ADMA水平与冠状动脉疾病风险之间的关联。然而，研究结果相互矛盾。
检索了PubMed、Web of Science、Embase、Ovid、Cochrane数据库，以识别截至2014年12月发表的符合条件的英文研究。基于加权平均差（WMD）及95%置信区间（CI）评估关联性。使用Begg检验和Egger检验分析发表偏倚。进行敏感性分析以评估结果稳定性。
荟萃分析共纳入16项病例对照研究，包括2939例患者和1774例对照。汇总结果表明，冠状动脉疾病患者的ADMA水平高于健康对照（WMD：0.248，95%CI：0.156 - 0.340；p = 1.16×10⁻⁷）。敏感性分析表明，我们的荟萃分析结果稳定。亚组分析发现，心肌梗死患者（WMD：0.397，95%CI：0.112 - 0.683；p = 0.0106）、稳定型心绞痛患者（WMD：0.197，95%CI：0.031 - 0.364；p = 0.02）和不稳定型心绞痛患者（WMD：0.857，95%CI：0.293 - 1.420；p = 0.003）中也存在类似模式。
荟萃分析结果表明，ADMA水平升高与冠状动脉疾病风险增加相关。
