title: Predictors of asymmetric dimethylarginine levels in patients with rheumatoid arthritis: the role of insulin resistance.
abstract: OBJECTIVE
  To determine whether demographic, inflammatory, and metabolic factors predict elevated asymmetric dimethylarginine (ADMA) levels in rheumatoid arthritis (RA).
  
  
  METHODS
  A total of 67 RA patients [mean age 56 ± 12 years, median disease duration 8 (3-15) years] were assessed. Routine biochemistry tests, lipid profile, glycaemic profile [glucose, insulin, homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI)], and inflammatory markers were measured in all patients. ADMA levels were measured by enzyme-linked immunosorbent assay (ELISA). Regression analyses were performed to identify predictors of ADMA in RA.
  
  
  RESULTS
  Regression analysis revealed that HOMA (β = 0.149, p = 0.003) was an independent predictor of ADMA in RA. From the drug factors, anti-hypertensive medication use was associated with lower ADMA levels (β = -0.081, p = 0.004). ADMA was not associated with RA disease-related parameters or any of the other cardiovascular risk factors that were assessed.
  
  
  CONCLUSIONS
  HOMA, a strong indicator of insulin resistance, seems to be the main predictor of elevated ADMA levels in RA patients; ADMA may reflect an important pathway linking abnormal insulin metabolism with endothelial dysfunction in RA.
authors: Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals, Dudley DY1 2HQ, West Midlands, UK. dimitroul@hotmail.com
authors: T
authors: T
authors: Dimitroulas
authors: A
authors: A
authors: Sandoo
authors: J J J C S
authors: JJ
authors: Veldhuijzen van Zanten
authors: J P
authors: JP
authors: Smith
authors: J
authors: J
authors: Hodson
authors: G S
authors: GS
authors: Metsios
authors: A
authors: A
authors: Stavropoulos-Kalinoglou
authors: G D
authors: GD
authors: Kitas
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D001172:Arthritis, Rheumatoid / Q000097:blood*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine