title: L-arginine metabolism in early-onset and late-onset pre-eclamptic pregnancies.
abstract: OBJECTIVE
  The present case-control study was undertaken to investigate l-arginine metabolism in pregnant women with early-onset and late-onset pre-eclampsia. Attempts were made to differentiate these two distinct diseases entities by using measured and derived parameters of l-arginine metabolism.
  
  
  METHODS
  Thirty-six patients with early-onset, 17 patients with late-onset pre-eclampsia and 15 healthy pregnant women at term were studied. Patients were categorized according to the weeks of gestation (< 34 vs. ≥ 34) at the appearance of clinical symptoms (hypertension + proteinuria). Venous samples were taken at gestational age of 29.8 ± 2.5, 36.1 ± 2.2 and 39.2 ± 1.2 weeks, respectively. L-arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), monomethylarginine (MMA) and l-ornithine were measured by LC-MS/MS method. L-arginine/ADMA, l-ornithine/l-arginine, ADMA/SDMA ratios and the arginine methylation index (arg-MI) were calculated.
  
  
  RESULTS
  Plasma levels of ADMA and MMA were significantly higher (p < 0.002) in pre-eclamptic patients than in healthy women. No significant differences could be detected between patients with early-onset and late-onset pre-eclampsia in either parameter studied. L-ornithine correlated positively with ADMA (r = 0.526, p < 0.001) and MMA (r = 0.533, p < 0.001) in the whole study population, and inversely with l-arginine (r = - 0.277, p < 0.044) in the pre-eclamptic group. When compared with maternal plasma in venous cord blood l-arginine was markedly reduced (p < 0.05) and there was a significant elevation in ADMA, SDMA, MMA and l-ornithine (p < 0.001, for each) without discernible differences between the study groups.
  
  
  CONCLUSIONS
  Parameters of l-arginine metabolism do not discriminate the early-onset from late-onset pre-eclampsia. Our study provided indirect evidences for the redirection of l-arginine-NOS to the l-arginine-arginase pathway.
authors.affiliation: Institute of Public Health and Health Promotion, Faculty of Health Sciences, University of Pécs, Pécs, Hungary. peter.tamas@aok.pte.hu
authors.forename: Péter
authors.initials: P
authors.lastname: Tamás
authors.forename: József
authors.initials: J
authors.lastname: Bódis
authors.forename: Endre
authors.initials: E
authors.lastname: Sulyok
authors.forename: Gábor L
authors.initials: GL
authors.lastname: Kovács
authors.forename: Eszter
authors.initials: E
authors.lastname: Hantosi
authors.forename: Gábor
authors.initials: G
authors.lastname: Molnár
authors.forename: Jens
authors.initials: J
authors.lastname: Martens-Lobenhoffer
authors.forename: Stefanie M
authors.initials: SM
authors.lastname: Bode-Böger
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D009952:Ornithine / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011247:Pregnancy; D055815:Young Adult; D019323:omega-N-Methylarginine / Q000097:blood*
chemical_list: D015415:Biomarkers; D019323:omega-N-Methylarginine; C018524:N,N-dimethylarginine; D001120:Arginine; D009952:Ornithine