title: Relationship between asymmetric dimethylarginine and endothelial dysfunction in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  In rheumatoid arthritis (RA), endothelial dysfunction caused by the inflammatory process increases the risk of cardiovascular disease. Asymmetric Dimethylarginine (ADMA) leads to vascular dysfunction, whereas atherosclerosis and increased ADMA is associated with cardiovascular disease risk factors. Flow-mediated Dilation (FMD) is a radiological method to demonstrate endothelial dysfunction. In the present study, we assessed the availability of ADMA as a marker for endothelial dysfunction in RA patients. ADMA can be used as a simple and cheaper method for the determination of endothelial dysfunction.
  
  
  METHODS
  Forty patients (1 male, 39 female) diagnosed with RA according to the classification criteria and 29 healthy volunteers (2 males, 27 females) were included in this study. ADMA was studied by enzyme-linked immunosorbent assay (ELISA). Chi-square, Fisher's exact test, Mann-Whitney U test, and Spearman's correlation tests were used for analytical analysis, and p<0.05 was considered as the level of statistical significance.
  
  
  RESULTS
  In our study, ADMA levels were significantly higher in RA patients. The ADMA level was inversely correlated with FMD. Although high levels of both C-reactive protein and ADMA were detected in patients with high disease activity, there was no statistically significant difference between these parameters (p=0.18). There were statistically significant negative correlations between FMD and age and disease duration (p=0.01, p=0.01). However, there were no statistically significant correlations with erythrocyte sedimentation rate, rheumatoid factor, and disease activity score (p=0.68). In RA patients, there was a statistically significant positive correlation between disease duration and ADMA, whereas a negative correlation was found between FMD and ADMA (p<0.05).
  
  
  CONCLUSIONS
  Our results support the hypothesis that ADMA may be used in the assessment of endothelial dysfunction in patients with RA. It will be cost-effective when commonly used. ADMA may be used in the assessment of endothelial dysfunction in patients with RA.
authors.affiliation: Department of Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Taşkın
authors.initials: T
authors.lastname: Şentürk
authors.affiliation: Department of Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Nergiz
authors.initials: N
authors.lastname: Yılmaz
authors.affiliation: Department of Rheumatology, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Sargın
authors.affiliation: Department of Radiology, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Kutsi
authors.initials: K
authors.lastname: Köseoğlu
authors.affiliation: Department of Biochemistry, Adnan Menderes University School of Medicine, Aydın, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Yenisey
keywords: Rheumatoid arthritis; asymmetric dimethylarginine; endothelial dysfunction; flow mediated dilation