title: Asymmetric dimethylarginine and arginine metabolites in women with and without a history of gestational diabetes.
abstract: OBJECTIVE
  Dysregulation of arginine metabolism, as evidenced by increased circulating levels of asymmetric dimethylarginine (ADMA), has been proposed as an early event in the natural history of cardiovascular disease. Since the diagnosis of gestational diabetes mellitus (GDM) identifies a patient population at increased future risk of cardiovascular disease later in life, we sought to characterize arginine metabolism in women with and without a history of recent GDM.
  
  
  METHODS
  In this prospective observational cohort study, 225 women (72 who had GDM; 153 who did not) underwent cardiometabolic characterization, including oral glucose tolerance test, at 1- and 3-years postpartum. Circulating ADMA and its stereoisomer symmetric dimethylarginine (SDMA) were measured by liquid chromatography-mass spectrometry at both visits.
  
  
  RESULTS
  Serum ADMA and SDMA were not significantly different between the GDM and non-GDM groups at either 1-year or 3-years postpartum. On multiple linear regression analyses, high-density-lipoprotein cholesterol (t=-2.62, p=0.009) and creatinine (t=-2.62, p=0.01) were independently associated with ADMA at 3-years, while creatinine (t=7.09, p<0.0001) and BMI (t=-2.24, p=0.026) predicted SDMA.
  
  
  CONCLUSIONS
  Women with recent GDM do not exhibit altered serum concentrations of ADMA or SDMA at 1- and 3-years postpartum, suggesting that ADMA dysregulation is not a feature of their cardiometabolic profile in the early years after delivery.
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Sumedha
authors.initials: S
authors.lastname: Arya
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Chang
authors.initials: C
authors.lastname: Ye
authors.affiliation: Division of Endocrinology, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto.
authors.forename: Philip W
authors.initials: PW
authors.lastname: Connelly
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hanley
authors.affiliation: Division of Obstetrics and Gynecology, University of Toronto, Toronto, Canada.
authors.forename: Mathew
authors.initials: M
authors.lastname: Sermer
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.affiliation: Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada; Division of Endocrinology, University of Toronto, Toronto, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada. Electronic address: ravi.retnakaran@sinaihealthsystem.ca.
authors.forename: Ravi
authors.initials: R
authors.lastname: Retnakaran
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D049590:Postpartum Period / Q000097:blood; D011247:Pregnancy; D011379:Prognosis
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine
keywords: ADMA; Asymmetric dimethylarginine; Cardiovascular; Gestational diabetes; SDMA