title: Asymmetric dimethylarginine as a risk marker for early-onset ischemic stroke in Indian population.
abstract: BACKGROUND
  Asymmetric dimethylarginine (ADMA), a circulating endogenous inhibitor of nitric oxide synthase, has been associated with the pathogenesis of atherosclerosis. The present study was initiated to investigate the role of ADMA as a biomarker of risk for early-onset ischemic stroke.
  
  
  METHODS
  Plasma ADMA levels were measured in 201 ischemic stroke patients aged between 15 and 50 years and 217, age and gender-matched healthy controls, by high performance liquid chromatography using pre-column derivatization with O-phthaldialdehyde.
  
  
  RESULTS
  Patients with ischemic stroke had significantly higher plasma ADMA compared with the controls (1.49 vs. 0.97 μmol/l, p < 0.001). After adjustment for vascular risk factors, increased ADMA was associated with stroke (OR=1.55, 95% CI 1.25-1.92, p < 0.001). Univariate analysis showed that ADMA was significantly associated with age, alcohol, smoking, hypertension, diabetes mellitus, low serum HDL-cholesterol and homocysteine. By multiple stepwise linear regression analysis, diabetes, HDL-cholesterol and homocysteine were found to be independent determinants of plasma ADMA.
  
  
  CONCLUSIONS
  Increased plasma ADMA is associated with increased risk for ischemic stroke in the young. Diabetes mellitus, HDL-cholesterol and homocysteine are independent predictors of elevation in plasma ADMA concentration.
authors.affiliation: Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Sopanahalli N
authors.initials: SN
authors.lastname: Mamatha
authors.forename: Dindagur
authors.initials: D
authors.lastname: Nagaraja
authors.forename: Mariamma
authors.initials: M
authors.lastname: Philip
authors.forename: Rita
authors.initials: R
authors.lastname: Christopher
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007194:India; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012306:Risk; D020521:Stroke / Q000097:blood* / Q000150:complications*; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine