title: Serial determinations of asymmetric dimethylarginine and homocysteine during pregnancy to predict pre-eclampsia: a longitudinal study.
abstract: OBJECTIVE
  To evaluate the usefulness of serial determinations of asymmetric dimethylarginine (ADMA) and homocysteine (Hcy) concentrations during pregnancy to predict pre-eclampsia, taking into account maternal obesity and B vitamin status.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Two obstetric referral hospitals.
  
  
  METHODS
  Two hundred and fifty-two of 411 women invited to participate in the study.
  
  
  METHODS
  The women made monthly visits from ≤20 weeks of gestation until delivery for measurements of plasma ADMA, Hcy, and vitamins B6 , B12, and folic acid, and for the recording of clinical information.
  
  
  METHODS
  Early elevations in plasma ADMA and Hcy related to the development of pre-eclampsia.
  
  
  RESULTS
  Of the 252 women who completed the study, 179 had no complications, 49 developed pre-eclampsia, and 24 presented with complications other than pre-eclampsia. ADMA and Hcy increased gradually throughout pregnancy in the pre-eclampsia group, independent of maternal B-vitamin status and obesity, but remained constant in women with no complications. Relative to the preceding month, ADMA and Hcy levels increased 1 month prior to the onset of pre-eclampsia: 124 ± 27 nmol (P < 0.001) and 1177 ± 278 nmol (P = 0.001), respectively, in the pre-eclampsia group. The group of women with no complications did not show any significant changes. Increases of 80 nmol ADMA and 1000 nmol Hcy at 1 month prior to the onset of pre-eclampsia demonstrated the best potential for prediction.
  
  
  CONCLUSIONS
  Increased ADMA and Hcy levels precede clinical manifestations of pre-eclampsia. Therefore, serial determinations of their concentrations may be helpful in identifying women at risk.
  
  
  CONCLUSIONS
  Increased ADMA and Hcy precede clinical pre-eclampsia and may identify women at risk.
authors.affiliation: Unit of Research in Medical Nutrition, Centro Médico Nacional Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: M
authors.initials: M
authors.lastname: López-Alarcón
authors.affiliation: Unit of Research in Medical Nutrition, Centro Médico Nacional Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: I
authors.initials: I
authors.lastname: Montalvo-Velarde
authors.affiliation: Hospital of Obstetrics and Gynaecology #3, Centro Médico La Raza, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: V S
authors.initials: VS
authors.lastname: Vital-Reyes
authors.affiliation: Hospital of Obstetrics and Gynaecology #3, Centro Médico La Raza, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: J C
authors.initials: JC
authors.lastname: Hinojosa-Cruz
authors.affiliation: Hospital of Obstetrics and Gynaecology #4, Luis Castelazo Ayala, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Leaños-Miranda
authors.affiliation: Unit of Research in Medical Nutrition, Centro Médico Nacional Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Basila
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D005260:Female; D005492:Folic Acid / Q000097:blood*; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008137:Longitudinal Studies; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D014803:Vitamin B Complex / Q000097:blood*; D014804:Vitamin B Deficiency / Q000097:blood* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D014803:Vitamin B Complex; C018524:N,N-dimethylarginine; D005492:Folic Acid; D001120:Arginine
keywords: ADMA; B vitamins; biomarkers; endothelial damage; homocysteine; pre-eclampsia