title: Evaluation of asymmetric dimethylarginine (ADMA) levels in children with growth hormone deficiency.
abstract: OBJECTIVE
  To investigate serum asymmetric dimethylarginine (ADMA) levels in children with isolated growth hormone deficiency (GHD) and to determine the effect of GH replacement therapy on these levels.
  
  
  METHODS
  31 patients diagnosed with isolated GHD and 29 age-and sex-matched healthy children were enrolled in the study. Height, weight and waist circumference were measured in all subjects. Fasting serum insulin-like growth factor-1 (IGF-1), IGF binding protein-3, glucose, insulin and lipid levels were evaluated. Serum ADMA levels were assessed using the enzyme-linked immunosorbent assay technique. The same evaluations were repeated on the 3rd and 6th months of treatment in 28 of the GHD cases.
  
  
  RESULTS
  There were no significant differences in ADMA levels between the patient and control groups [0.513±0.130 (0.291-0.820) µmol/L vs. 0.573±0.199 (0.241-1.049) µmol/L]. There was a positive correlation between serum ADMA and HbA1c levels in the control group. In the GHD cases, ADMA levels negatively correlated with high-density lipoprotein levels and positively correlated with low-density lipoprotein levels. There was also a significant increase in ADMA levels in patients receiving GH therapy compared to pre-treatment levels [serum ADMA level, 1.075±0.133 (0.796-1.303) µmol/L at the 3rd month and 0.923±0.121 (0.695-1.159) µmol/L at the 6th month of treatment]. There was a negative correlation between ADMA levels and homeostasis model assessment of insulin resistance values at the 6th month evaluation. There were no relationships between ADMA levels and age, sex, or pubertal state either before or during the treatment.
  
  
  CONCLUSIONS
  Serum ADMA levels were found to be similar in patients with GHD and in healthy children. However, serum ADMA levels showed a significant increase in GHD patients following GH replacement therapy.
authors.affiliation: Sami Ulus Gynecology and Obstetrics, Children Health and Diseases Training and Research Hospital, Pediatric Endocrinology Clinic, Ankara, Turkey. E-ma-il: asanonder@yahoo.com.
authors.forename: Aşan
authors.initials: A
authors.lastname: Önder
authors.forename: Zehra
authors.initials: Z
authors.lastname: Aycan
authors.forename: Cemile
authors.initials: C
authors.lastname: Koca
authors.forename: Merve
authors.initials: M
authors.lastname: Ergin
authors.forename: Semra
authors.initials: S
authors.lastname: Çetinkaya
authors.forename: Sebahat Yılmaz
authors.initials: SY
authors.lastname: Ağladıoğlu
authors.forename: Havva Nur
authors.initials: HN
authors.lastname: Peltek Kendirci
authors.forename: Veysel Nijat
authors.initials: VN
authors.lastname: Baş
mesh_terms: D000293:Adolescent; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006130:Growth Disorders / Q000097:blood* / Q000188:drug therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D011379:Prognosis
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; C018524:N,N-dimethylarginine; D007334:Insulin-Like Growth Factor I; D001120:Arginine