Increased serum asymmetric dimethylarginine levels in primary dysmenorrhea.
BACKGROUND
Primary dysmenorrhea is a common disorder among young women, and uterine ischemia plays an important role in pelvic pain. Asymmetric dimethylarginine (ADMA) is accepted as a strong marker of endothelial dysfunction.


OBJECTIVE
To investigate the role of ADMA in primary dysmenorrhea.


METHODS
Thirty-three patients with primary dysmenorrhea and 29 healthy controls were evaluated in a hospital outpatient clinic-based study. Secondary causes of dysmenorrhea had been ruled out in each patient. LDL cholesterol, triglycerides measured and body mass index were also calculated. Blood samples for determination of ADMA concentration were drawn on the 3rd day of menses in each woman. Groups were compared for statistically significant difference by Mann-Whitney U test.


RESULTS
Groups did not differ in age or hormone levels. ADMA level was higher in women with dysmenorrhea compared to healthy controls (Mann-Whitney U test, Z = -2.24, p = 0.025). ADMA levels showed positive correlation with age and erythrocyte sedimentation rate in the first group (Spearman's rho = 0.360, p = 0.040, and r = 0.379, p = 0.029, respectively). Although erythrocyte sedimentation rate and C-reactive protein (CRP) were positively correlated, no significant correlations were found between high-sensitivity CRP and ADMA level in the first group (Spearman's rho = 0.048, p = 0.749).


CONCLUSIONS
ADMA concentrations are elevated in primary dysmenorrhea compared to healthy controls. This suggests that endothelial dysfunction plays a role in primary dysmenorrhea.
Akdemir
Nermin
N
Department of Obstetrics and Gynecology, HM Kecioren Research and Education Hospital, Ankara, Turkey. drnerminakdemir@yahoo.com
Cinemre
Hakan
H
Bilir
Cemil
C
Akin
Okhan
O
Akdemir
Ramazan
R
D000293:Adolescent; D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D004412:Dysmenorrhea / Q000097:blood* / Q000209:etiology*; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood; D009569:Nitric Oxide / Q000378:metabolism; D017699:Pelvic Pain / Q000097:blood; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood; D014599:Uterus / Q000098:blood supply; D055815:Young Adult
D015415:Biomarkers; D008078:Cholesterol, LDL; D014280:Triglycerides; D009569:Nitric Oxide; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine