Asymmetric dimethylarginine as a risk marker for early-onset ischemic stroke in Indian population.
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.
Mamatha
Sopanahalli N
SN
Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Nagaraja
Dindagur
D
Philip
Mariamma
M
Christopher
Rita
R
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
D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine