Dimethylarginines, blood glucose, and C-reactive protein in patients with acute myocardial infarction

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• 作者：Aur&eacute ; lie Gudjoncik^a ; ^b ; Marianne Zeller^a ; ^{Marianne.zeller@u-bourgogne.fr" class="auth_mail" title="E-mail the corresponding author} ; Julie Lorin^a ; Eve Rigal^a ; Yves Cottin^a ; ^b ; Catherine Vergely^a ; Luc Rochette^a
• 关键词：ACE inhibitor ; angiotensin converting enzyme inhibitor ; ARB ; angiotensin II receptor blocker ; ADMA ; asymmetric dimethylarginine ; BMI ; body mass index ; CAD ; coronary artery disease ; CK ; creatine kinase ; CRP ; C-reactive protein ; DBP ; diastolic blood pressure ; HR ; heart rate ; EC ; endothelial cell ; HbA1c ; glycated hemoglobin ; HDL-C ; high-density lipoprotein-cholesterol ; HPLC ; high-performance liquid chromatography ; ICU ; intensive care unit ; LDL-C ; low-density lipoprotein-cholesterol ; LVEF ; left vent
• 刊名：Clinical Trials and Regulatory Science in Cardiology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：16
• 期：Complete
• 页码：6-11
• 全文大小：379 K

文摘

Asymmetric dimethylarginine (ADMA), and its symmetrical stereoisomer (SDMA) — as methylated products of l-arginine, decrease nitric oxide (NO) availability. Their elevated levels in diabetes increase the risk of acute myocardial infarction (MI), through endothelial dysfunction.

Aims

We investigated the relationship between circulating levels of ADMA, SDMA and functional relevant parameters in patients with acute MI.

Methods

Prospective study from 31 MI patients hospitalized < 12 h after symptom onset. Blood samples were taken on admission and serum levels of ADMA, SDMA and l-arginine were determined using high-performance liquid chromatography (HPLC).

Results

Mean age was 65y, most were male, hypertensive, 1/3rd were current smokers, or had a history of CAD and 23% were diabetic. ADMA and l-arginine values were similar whatever the risk factor, except for ADMA that was positively correlated with blood glucose (r = 0.37). In contrast, SDMA was correlated with age (r = 0.43), and admission glucose (r = 0.57). SDMA was elevated in hypertension, prior CAD, statin therapy and showed a trend toward an increase in diabetic patients (p = 0.191). Moreover, there was a trend toward an elevation of SDMA with decreased LVEF (r = − 0.25). In multivariate linear regression analysis, blood glucose was an estimate of SDMA (ß = 0.373, p = 0.025), beyond traditional markers of dimethylarginines including kidney failure.

Conclusion

Our study showed that in patients with acute MI, SDMA, and only weakly ADMA, are associated with admission blood glucose, beyond traditional dimethylarginine determinants and may therefore have biological activity beyond renal function.