Asymmetric dimethylarginine (ADMA) as a possible risk marker for ischemic stroke.
BACKGROUND
Asymmetric dimethylarginine (ADMA) affects vascular function by blocking nitric oxide synthesis. We examined the relationship of ADMA concentration to vascular risk factors in subjects who have undergone annual medical check-up.


METHODS
ADMA concentration, lipid profile and vascular risk factors were assessed during an annual medical examination in 116 subjects (mean age 58.7years). Univariate and multivariate analyses were carried out to assess factors associated with ADMA concentration. ADMA concentration was also assessed in 50 age-matched patients with ischemic stroke.


RESULTS
Mean serum ADMA concentration was significantly higher in the ischemic stroke patients than the medical check-up subjects (0.461+/-0.076 versus 0.433+/-0.056mumol/l; P=0.022). Univariate analysis showed that ADMA concentration in the medical check-up subjects was significantly associated with age, hypertension, dyslipidemia, fasting blood glucose, total and LDL cholesterol concentrations. Multiple stepwise linear regression analysis showed that hypertension (beta=0.25, P=0.008) and dyslipidemia (beta=0.19, P =0.048) were significant independent determinants of ADMA concentration. ADMA concentration increased progressively with number of vascular risk factors, with a significant (P=0.001) difference between subjects with no risk factors and subjects with > or =2 risk factors.


CONCLUSIONS
Serum ADMA concentration was significantly associated with vascular risk factors in subjects undergoing routine medical check-up. ADMA concentration warrants further examination as a possible marker of future development of ischemic stroke.
Nishiyama
Yasuhiro
Y
Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. nomo16@nms.ac.jp
Ueda
Masayuki
M
Katsura
Ken-Ichiro
K
Otsuka
Toshiaki
T
Abe
Arata
A
Nagayama
Hiroshi
H
Katayama
Yasuo
Y
D000367:Age Factors; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000032:analysis / Q000097:blood; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001786:Blood Glucose / Q000502:physiology; D002545:Brain Ischemia / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D008078:Cholesterol, LDL / Q000097:blood; D050171:Dyslipidemias / Q000097:blood / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000096:biosynthesis; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D015854:Up-Regulation / Q000502:physiology
D015415:Biomarkers; D001786:Blood Glucose; D008078:Cholesterol, LDL; D009569:Nitric Oxide; C018524:N,N-dimethylarginine; D001120:Arginine