Relationship of asymmetric dimethylarginine and homocysteine to vascular aging in systemic lupus erythematosus patients.
OBJECTIVE
Systemic lupus erythematosus (SLE) is independently associated with accelerated atherosclerosis and premature arterial stiffening. Asymmetric dimethylarginine (ADMA) and homocysteine are mechanistically interrelated mediators of endothelial dysfunction and correlates of atherosclerosis in the general population. The aim of this study was to assess the relationship of ADMA and homocysteine to subclinical vascular disease in patients with SLE.


METHODS
One hundred twenty-five patients with SLE who were participating in a study of cardiovascular disease underwent clinical and laboratory assessment, carotid artery ultrasonography to detect atherosclerosis, and radial artery applanation tonometry to measure arterial stiffness.


RESULTS
Neither ADMA nor homocysteine correlated with the presence or extent of carotid atherosclerosis. In contrast, ADMA was significantly related to the arterial stiffness index. Independent correlates of arterial stiffening included the ADMA concentration, the presence of diabetes mellitus, older age at the time of diagnosis, longer disease duration, and the absence of anti-Sm or anti-RNP antibodies. A secondary multivariable analysis substituting homocysteine for ADMA demonstrated comparable relationships with arterial stiffness (r(2) = 0.616 for homocysteine and r(2) = 0.595 for ADMA).


CONCLUSIONS
ADMA and homocysteine are biomarkers for and may be mediators of premature arterial stiffening in patients with SLE. Because arterial stiffness has independent prognostic value for cardiovascular morbidity and mortality, its predictors may identify patients who are at increased risk of cardiovascular disease.
Weill Cornell Medical College and Hospital for Special Surgery, New York, New York 10021, USA.
Michelle
M
Perna
Mary J
MJ
Roman
Deborah R
DR
Alpert
Mary K
MK
Crow
Michael D
MD
Lockshin
Lisa
L
Sammaritano
Richard B
RB
Devereux
John P
JP
Cooke
Jane E
JE
Salmon
D000328:Adult; D000375:Aging / Q000378:metabolism* / Q000473:pathology; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D002339:Carotid Arteries / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D011379:Prognosis; D012720:Severity of Illness Index; D014652:Vascular Diseases / Q000150:complications / Q000378:metabolism* / Q000473:pathology
C487735:dimethylarginine; D006710:Homocysteine; D001120:Arginine