title: Increased asymmetric dimethylarginine and enhanced inflammation are associated with impaired vascular reactivity in women with endometriosis.
abstract: OBJECTIVE
  Enhanced inflammatory responses which may inhibit vascular reactivity, are associated with endometriosis development. Asymmetric dimethylarginine (ADMA), an inhibitor of endogenous nitric oxide synthase, is also implicated in endothelial dysfunction. We aimed to determine whether plasma ADMA and systemic inflammation are associated with endothelial function in women with endometriosis.
  
  
  METHODS
  We evaluated 41 women with and 28 women without endometriosis. Plasma levels of lipids and inflammatory markers such as high sensitive-C reactive protein (hs-CRP), serum amyloid protein A (SAA), and interleukin-6 (IL-6) were measured in the two groups. We also measured levels of ADMA and symmetric dimethylarginine (SDMA). High-resolution ultrasonography measured flow-mediated vasodilation (FMD) to assess vasodilatory responses.
  
  
  RESULTS
  FMD was significantly lower in women with endometriosis compared to those without endometriosis (8.39 ± 0.43% vs 10.79 ± 0.54%, P = 0.001). While plasma lipid levels did not differ significantly between groups, levels of AMDA, but not SDMA, were significantly higher in women with endometriosis (409.7 ± 10.1 pmol/L vs 383.0 ± 48.3 pmol/L, P = 0.04). Inflammatory markers were also significantly higher in these women (hs-CRP: 1053.3 ± 252.0 ng/mL vs 272.0 ± 83.3 ng/mL, P = 0.02; SAA: 8.00 ± 1.53 μg/mL vs 3.82 ± 0.42 μg/mL, P = 0.04; IL-6: 2.73 ± 0.75 pg/mL vs 1.05 ± 0.60 pg/mL, P = 0.04). FMD was negatively correlated with plasma levels of ADMA (r = -0.37, P=0.01) and log hs-CRP (r = -0.34, P = 0.01).
  
  
  CONCLUSIONS
  Increased plasma ADMA levels and enhanced inflammation are associated with inhibited endothelial function in women with endometriosis.
authors: Department of Obstetrics and Gynecology, Aichi Medical University, Nagakute, Aichi 480-1195, Japan.
authors: Shoko
authors: S
authors: Kinugasa
authors: Koichi
authors: K
authors: Shinohara
authors: Akihiko
authors: A
authors: Wakatsuki
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D004715:Endometriosis / Q000097:blood* / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007564:Japan; D016018:Least-Squares Analysis; D008055:Lipids / Q000097:blood; D012044:Regression Analysis; D000685:Serum Amyloid A Protein / Q000032:analysis; D018608:Ultrasonography, Doppler; D015854:Up-Regulation; D014664:Vasodilation
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D008055:Lipids; D000685:Serum Amyloid A Protein; C024917:symmetric dimethylarginine; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine