title: High levels of asymmetric dimethylarginine are strongly associated with low HDL in patients with acute myocardial infarction.
abstract: OBJECTIVE
  Low levels of high-density lipoprotein (HDL) cholesterol are associated with an increased risk of acute myocardial infarction possibly through impaired endothelial atheroprotection and decreased nitric oxide (NO) bioavailability. Asymmetric dimethylarginine (ADMA) mediates endothelial function by inhibiting nitric oxide synthase activity. In patients with acute myocardial infarction, we investigated the relationship between serum levels of HDL and ADMA.
  
  
  RESULTS
  Blood samples from 612 consecutive patients hospitalized for acute MI <24 hours after symptom onset were taken on admission. Serum levels of ADMA, its stereoisomer, symmetric dimethylarginine (SDMA) and L-arginine were determined using high-performance liquid chromatography. Patients with low HDL (<40 mg/dL for men and <50 mg/dL for women) were compared with patients with higher HDL. Most patients (59%) had low HDL levels. Median ADMA levels were markedly higher in the low HDL group (0.69 vs. 0.50 µmole/L, p<0.001). In contrast, SDMA and L-arginine levels were similar for the two groups (p = 0.120 and p = 0.064). Notably, ADMA, but not SDMA or L-arginine, was inversely correlated with HDL (r = -0.311, p<0.001). In stratified analysis, this relationship was only found for low HDL levels (r = -0.265, p<0.001), but not when HDL levels were higher (r = -0.077, p = 0.225). By multivariate logistic regression analysis, ADMA level was strongly associated with low HDL levels (OR(95%CI):6.06(3.48-10.53), p<0.001), beyond traditional confounding factors.
  
  
  CONCLUSIONS
  Our large population-based study showed for the first time a strong inverse relationship between HDL and ADMA in myocardial infarction patients, suggesting a functional interaction between HDL and endothelium, beyond metabolic conditions associated with low HDL levels.
authors.affiliation: INSERM UMR866- Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Lorin
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Guilland
authors.forename: Claudia
authors.initials: C
authors.lastname: Korandji
authors.forename: Claude
authors.initials: C
authors.lastname: Touzery
authors.forename: Florence
authors.initials: F
authors.lastname: Bichat
authors.forename: Aline
authors.initials: A
authors.lastname: Chagnon
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
authors.forename: Luc
authors.initials: L
authors.lastname: Rochette
authors.forename: Catherine
authors.initials: C
authors.lastname: Vergely
authors.forename: Marianne
authors.initials: M
authors.lastname: Zeller
mesh_terms: D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood*; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*
chemical_list: D008075:Lipoproteins, HDL; C024917:symmetric dimethylarginine; D001120:Arginine