Increased asymmetric dimethylarginine levels in young men with familial Mediterranean fever (FMF): is it early evidence of interaction between inflammation and endothelial dysfunction in FMF?
OBJECTIVE
Unlike in many other chronic inflammatory rheumatic diseases, studies investigating endothelial dysfunction and atherosclerosis in familial Mediterranean fever (FMF) are limited, and the results are controversial. Asymmetric dimethylarginine (ADMA) is considered an indicator for endothelial dysfunction and a sensitive marker for cardiovascular risk. There have been no reports on serum ADMA levels in patients with FMF.


METHODS
We aimed (1) to determine serum ADMA concentrations in 38 young male patients with FMF and 23 age- and body mass index-matched healthy volunteers; (2) to evaluate its correlations with MEFV mutations, C-reactive protein (CRP) levels, and lipid profile; and (3) to compare effects of colchicine on circulating ADMA concentrations.


RESULTS
In patients with FMF, ADMA and CRP levels were higher than in healthy controls. The mean levels of ADMA and CRP were higher during acute attacks than in attack-free periods. Patients taking colchicine had lower serum ADMA levels than non-colchicine users. There was a positive strong correlation between ADMA and CRP in patients with FMF. Stepwise linear regression analysis in patients with FMF revealed that age and CRP levels were independently associated with serum ADMA levels.


CONCLUSIONS
Our data imply that higher serum ADMA levels in FMF may indicate inflammation-related "endothelial dysfunction." It seems likely that regular use of colchicine is effective in preventing the development of and reversing not only amyloidosis but also endothelial dysfunction in patients with FMF.
Terekeci
Hakan M
HM
Division of Internal Medicine, GATA Haydarpasa Training Hospital, Istanbul, Turkey. mhterekeci@yahoo.com.tr
Oktenli
Cagatay
C
Ozgurtas
Taner
T
Nalbant
Selim
S
Top
Cihan
C
Celik
Serkan
S
Tapan
Serkan
S
Kucukardali
Yasar
Y
Sanisoglu
Yavuz S
YS
Solmazgul
Emrullah
E
Sahan
Burak
B
Sayan
Ozkan
O
D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003078:Colchicine / Q000627:therapeutic use; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D010505:Familial Mediterranean Fever / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D055815:Young Adult
D008055:Lipids; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine; D003078:Colchicine