title: Elevated asymmetric dimethylarginine in plasma: an early marker for endothelial dysfunction in non-alcoholic fatty liver disease?
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) is associated with cardiovascular disease. Asymmetric dimethylarginine (ADMA) is a novel marker of endothelial dysfunction and atherosclerosis. We aimed to investigate circulating ADMA concentrations in biopsy proven NAFLD and also to search its association with carotid atherosclerosis.
  
  
  METHODS
  Sixty-seven nondiabetic and normotensive patients with NAFLD and 35 healthy controls were enrolled. Plasma ADMA was measured along with glucose, lipids and insulin levels. Insulin resistance (IR) was assessed by homeostasis model assessment-estimated insulin resistance (HOMA-IR) method. Carotid atherosclerosis was evaluated by carotid artery intima-media thickness (CIMT) using carotid ultrasonography.
  
  
  RESULTS
  ADMA levels and CIMT measurements were significantly higher in NAFLD group than the controls. However, the difference regarding the CIMT disappeared when the findings were adjusted according to the metabolic parameters and insulin sensitivity. In contrast, the difference for ADMA remained significant between two groups. No significant association was found between ADMA, CIMT and histopathological findings.
  
  
  CONCLUSIONS
  Plasma ADMA levels are increased in subjects with NAFLD. This increase seems to be independent from traditional cardiovascular risk factors, insulin resistance and liver histology. Circulating ADMA may be an earlier marker of vascular damage with respect to CIMT in subjects with NAFLD.
authors.affiliation: Department of Gastroenterology, Gulhane Medical School, Ankara, Turkey.
authors.forename: Teoman
authors.initials: T
authors.lastname: Dogru
authors.forename: Halil
authors.initials: H
authors.lastname: Genc
authors.forename: Serkan
authors.initials: S
authors.lastname: Tapan
authors.forename: Cemal Nuri
authors.initials: CN
authors.lastname: Ercin
authors.forename: Fatih
authors.initials: F
authors.lastname: Ors
authors.forename: Fatih
authors.initials: F
authors.lastname: Aslan
authors.forename: Muammer
authors.initials: M
authors.lastname: Kara
authors.forename: Erdim
authors.initials: E
authors.lastname: Sertoglu
authors.forename: Sait
authors.initials: S
authors.lastname: Bagci
authors.forename: Ismail
authors.initials: I
authors.lastname: Kurt
authors.forename: Alper
authors.initials: A
authors.lastname: Sonmez
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D005234:Fatty Liver / Q000097:blood*; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D055815:Young Adult
chemical_list: D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine