title: Association of Asymmetric Dimethylarginine With Acute Pancreatitis-Induced Hyperglycemia.
abstract: OBJECTIVE
  The objective of this study was to investigate the relationship between asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, oxidative-nitrosative damage, and glucoregulation in acute pancreatitis (AP).
  
  
  METHODS
  The study evaluated serum levels of ADMA, nitrotyrosine, and urinary 8-hydroxydeoxyguanosine in 40 male patients hospitalized for AP at baseline and at 2 and 10 days of treatment, respectively. The patients were classified into a mild and a moderately severe AP group (MAP and MSAP, respectively) according to Atlanta classification criteria. Glycemic status was evaluated by a 75-g oral glucose tolerance test 1 month after AP onset. Forty age-matched healthy subjects served as control subjects.
  
  
  RESULTS
  Significant decrease of ADMA and increased levels of nitrotyrosine and urinary 8-hydroxydeoxyguanosine were found in MSAP, but not in MAP at baseline, with ADMA correction toward control levels at the 10th day of treatment. Fructosamine was found to significantly influence ADMA levels (r = -0.362, P = 0.002). After AP recovery, either impaired glucose tolerance or diabetes was identified with the oral glucose tolerance test in 10.5% and 92.8% of patients with MAP and MSAP, respectively.
  
  
  CONCLUSIONS
  Insufficient inhibition of nitric oxide synthesis, through reduced bioavailability of ADMA, might be a novel significant contributory factor to the severity of AP and subsequent development of hyperglycemia.
authors.affiliation: From the *Department of Internal Medicine, University Hospital Split, Split, Croatia; †Department of Internal Medicine, University Hospital Mostar, Mostar, Federation of Bosnia and Herzegovina; ‡Department of Anesthesiology, Merkur University Hospital, Zagreb, Croatia, §Polyclinic "Meter", Imotski, Croatia; and ∥Department of Laboratory Medicine, Merkur University Hospital, Zagreb, Croatia.
authors.forename: Gorana
authors.initials: G
authors.lastname: Trgo
authors.forename: Ivan
authors.initials: I
authors.lastname: Zaja
authors.forename: Ante
authors.initials: A
authors.lastname: Bogut
authors.forename: Vesna
authors.initials: V
authors.lastname: Kovacic Vicic
authors.forename: Ivana
authors.initials: I
authors.lastname: Meter
authors.forename: Marijana
authors.initials: M
authors.lastname: Vucic Lovrencic
authors.forename: Maja
authors.initials: M
authors.lastname: Radman
mesh_terms: D000080242:8-Hydroxy-2'-Deoxyguanosine; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000652:urine; D004797:Enzyme-Linked Immunosorbent Assay; D005440:Fluid Therapy / Q000379:methods; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology* / Q000652:urine; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000150:complications* / Q000652:urine; D011446:Prospective Studies; D000077325:Ringer's Lactate; D012720:Severity of Illness Index; D013997:Time Factors; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; C002744:3-nitrotyrosine; D014443:Tyrosine; C018524:N,N-dimethylarginine; D000080242:8-Hydroxy-2'-Deoxyguanosine; D001120:Arginine; D003849:Deoxyguanosine