title: Diabetic retinopathy is associated with elevated serum asymmetric and symmetric dimethylarginines.
abstract: OBJECTIVE
  Asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and l-arginine directly influence nitric oxide production. Our objective was to test whether serum ADMA, SDMA, or l-arginine levels correlate with diabetic retinopathy subtype or severity.
  
  
  METHODS
  A total of 162 subjects with type 1 diabetes and 343 with type 2 diabetes, of whom 329 subjects had no diabetic retinopathy, 27 had nonproliferative diabetic retinopathy (NPDR), 101 had proliferative diabetic retinopathy (PDR), and 107 had clinically significant macular edema (CSME), were recruited. Blinding diabetic retinopathy was defined as severe NPDR, PDR, or CSME. Serum ADMA, SDMA, and l-arginine concentrations were determined by mass spectroscopy.
  
  
  RESULTS
  In multivariate analysis, blinding diabetic retinopathy, PDR, and nephropathy were associated with significantly increased serum levels of ADMA (P < 0.001), SDMA (P < 0.001), and l-arginine (P = 0.001). Elevated ADMA (P < 0.001) and SDMA (P < 0.001) were also significantly associated with CSME.
  
  
  CONCLUSIONS
  Severe forms of diabetic retinopathy are associated with elevated serum ADMA, SDMA, and l-arginine. Further investigation is required to determine whether these findings are of clinical relevance.
authors.affiliation: Department of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, Australia.
authors.forename: Sotoodeh
authors.initials: S
authors.lastname: Abhary
authors.forename: Nicholas
authors.initials: N
authors.lastname: Kasmeridis
authors.forename: Kathryn P
authors.initials: KP
authors.lastname: Burdon
authors.forename: Abraham
authors.initials: A
authors.lastname: Kuot
authors.forename: Malcolm J
authors.initials: MJ
authors.lastname: Whiting
authors.forename: Wai Ping
authors.initials: WP
authors.lastname: Yew
authors.forename: Nikolai
authors.initials: N
authors.lastname: Petrovsky
authors.forename: Jamie E
authors.initials: JE
authors.lastname: Craig
mesh_terms: D000873:Anthracenes / Q000737:chemistry; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood / Q000737:chemistry; D015415:Biomarkers / Q000097:blood; D001766:Blindness / Q000453:epidemiology / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D003930:Diabetic Retinopathy / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008958:Models, Molecular; D015999:Multivariate Analysis; D011407:Propane / Q000031:analogs & derivatives* / Q000097:blood / Q000737:chemistry
chemical_list: D000873:Anthracenes; D015415:Biomarkers; C024917:symmetric dimethylarginine; D001120:Arginine; D011407:Propane
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