title: Assessment of the relationship between asymmetric dimethylarginine and severity of erectile dysfunction and coronary artery disease.
abstract: The plasma concentration of asymmetrical dimethylarginine (ADMA), an inhibitor of nitric oxide synthase, has been linked to endothelial dysfunction. We investigated the relation between plasma ADMA concentration and severity of erectile dysfunction (ED) and coronary artery disease (CAD). We measured plasma levels of ADMA in 92 male patients. Patients were divided into three groups: group 1 (n = 41), patients with ED and without CAD; group 2 (n = 29), patients with stable CAD; group 3 (n = 22), control group (patients without CAD or ED). Erectile function was evaluated by the erectile function domain of the international index of erectile function (IIEF-EFD) a validated 15-item self-administered questionnaire. Erectile function is specifically addressed by six questions that form the so-called erectile function domain of the questionnaire. Each question is scored 0-5. ED is defined as any value < 26. Patients with CAD who have stable angina pectoris were selected after coronary angiography. ADMA was analyzed by ELISA method. Group 1 had significantly higher concentrations of plasma ADMA than groups 2 and 3 (respectively, 0.75 ± 0.40 vs. 0.50 ± 0.30, P = 0.013; 0.75 ± 0.40 vs. 0.50 ± 0.25, P = 0.021). There was negative correlation between ADMA and IIEF-EFD score in all groups (n = 92) (r = -0.322, P = 0.002). In a multiple logistic regression analysis adjusting for age, hyperlipidemia, ADMA remained independent predictor for severe ED. Odds ratio for plasma ADMA was 14.151 (1.101-181.940; P = 0.042). First of all, this study provides that ADMA concentrations are significantly higher in patients who have ED when compared to patients with CAD and controls. Second, there was a negative correlation between ADMA and severity of ED. Elevating levels of circulating ADMA is an independent risk factor for severe of ED, and ADMA may be a link between CAD and ED.
authors.affiliation: Department of Urology, Faculty of Medicine, Trakya University, Kocasinan Mah, Karabıcak Apt., No. 1, 22030, Edirne, Turkey. taktoz01@yahoo.com
authors.forename: Tevfik
authors.initials: T
authors.lastname: Aktoz
authors.forename: Meryem
authors.initials: M
authors.lastname: Aktoz
authors.forename: Ersan
authors.initials: E
authors.lastname: Tatlı
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kaplan
authors.forename: Fatma N
authors.initials: FN
authors.lastname: Turan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Barutcu
authors.forename: Irfan H
authors.initials: IH
authors.lastname: Atakan
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Demir
authors.forename: Armagan
authors.initials: A
authors.lastname: Altun
mesh_terms: D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D007172:Erectile Dysfunction / Q000097:blood* / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine