Malle Oliver, Trummer Christian, Theiler-Schwetz Verena, Meinitzer Andreas, Keppel Martin H, Grübler Martin R, Tomaschitz Andreas, Voelkl Jakob, März Winfried, Pilz Stefan
Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria.
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria.
J Clin Med. 2020 Nov 30;9(12):3895. doi: 10.3390/jcm9123895.
Nitric oxide (NO) synthesis markers, comprising L-homoarginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), are significantly associated with cardiovascular events and mortality. Being involved in NO pathways, they may be of high importance regulating vascular tone and arterial hypertension, but data on this topic are sparse and controversial. In this study, we evaluated whether these NO synthesis markers are associated with blood pressure values and pulse wave velocity (PWV). This analysis was based on the data of the Styrian Vitamin D Hypertension Trial, which included adults with arterial hypertension. We analyzed correlations of NO synthesis markers with 24 h ambulatory blood pressure values and PWV (primary outcomes), as well as with anthropometric and laboratory data. A total of 509 patients were included in the present analysis. The mean age was 61.2 ± 10.5 years, mean PWV was 8.6 ± 2.4 m/s, mean 24 h systolic blood pressure was 127.5 ± 13.8 mmHg and mean 24 h diastolic blood pressure was 76.4 ± 9.5 mmHg. In bivariate analyses, there was a significant positive correlation between homoarginine and 24 h diastolic blood pressure (r = 0.1; 0.02), which was revealed to be no longer significant after adjustment for age, gender and glomerular filtration rate (GFR) in multivariate regression analysis. No other significant correlations of any NO synthesis markers with blood pressure or PWV were observed. In line with previous studies, there were inverse associations between homoarginine and age and between ADMA or SDMA and GFR ( < 0.05 for all). This study did not reveal a significant association between homoarginine, ADMA or SDMA and blood pressure or PWV in hypertensive adults. These results suggested that the associations of these parameters with adverse outcome may not be mediated by hypertension and/or endothelial dysfunction.
一氧化氮（NO）合成标志物，包括L-高精氨酸、不对称二甲基精氨酸（ADMA）和对称二甲基精氨酸（SDMA），与心血管事件及死亡率显著相关。由于它们参与NO途径，可能在调节血管张力和动脉高血压方面具有重要意义，但关于这一主题的数据稀少且存在争议。在本研究中，我们评估了这些NO合成标志物是否与血压值及脉搏波速度（PWV）相关。该分析基于施蒂里亚维生素D高血压试验的数据，该试验纳入了患有动脉高血压的成年人。我们分析了NO合成标志物与24小时动态血压值及PWV（主要结局）之间的相关性，以及与人体测量和实验室数据之间的相关性。本分析共纳入509例患者。平均年龄为61.2±10.5岁，平均PWV为8.6±2.4米/秒，平均24小时收缩压为127.5±13.8毫米汞柱，平均24小时舒张压为76.4±9.5毫米汞柱。在双变量分析中，高精氨酸与24小时舒张压之间存在显著正相关（r = 0.1；P = 0.02），但在多变量回归分析中，在对年龄、性别和肾小球滤过率（GFR）进行校正后，该相关性不再显著。未观察到任何NO合成标志物与血压或PWV之间的其他显著相关性。与先前的研究一致，高精氨酸与年龄之间以及ADMA或SDMA与GFR之间存在负相关（均P < 0.05）。本研究未发现高精氨酸、ADMA或SDMA与高血压成年人的血压或PWV之间存在显著关联。这些结果表明，这些参数与不良结局之间的关联可能不是由高血压和/或内皮功能障碍介导的。
