Association of Asymmetric Dimethylarginine and Nitric Oxide with Cardiovascular Risk in Patients with End-Stage Liver Disease

Dragičević, Maro; Košuta, Iva; Kruezi, Egon; Lovrenčić, Marijana Vučić; Mrzljak, Anna

doi:10.3390/medicina56110622

Cited by 4 publications

(4 citation statements)

References 44 publications

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“…In rats model of liver cirrhosis by bile duct ligation, Sheen JM et al [39] found that asymmetric dimethylarginine (ADMA) levels in the plasma and liver were higher in the experimental group than those in control group. Consistent with this result, plasma ADMA levels are elevated in cirrhotic patients [40] . ADMA, an analogue of Arg, is synthesized by protein methyltransferases and competes with Arg for nitric oxide synthase after proteolytic degradation.…”

Section: Discussionsupporting

confidence: 74%

Predictive value of serum amino acids as metabolite biomarkers in cirrhosis: a systematic review and meta-analysis

Xiao

et al. 2023

Preprint

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Introduction To review existing studies and perform a meta-analysis to clarify the value of serum amino acid levels in patients with cirrhosis as a potential biomarker for predicting cirrhosis. Methods Literature retrieved from 8 databases up to 31 December 2022, and were screened according to inclusion criteria. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to assess the risk of bias in the included literature. A random effects model for amino acid concentrations in meta-analysis was used to calculate mean differences (MD) and 95% confidence intervals (95% CI). I2 statistic was used to measure study heterogeneity. This study was registered with PROSPERO. Results A total of 1380 records were retrieved and 19 studies with 2073 individuals (831 in the cirrhosis group and 1242 in the healthy control group) were included after screening. The quality of the included studies was generally high. Qualitative analysis of 19 studies including 23 amino acids. Meta-analysis of 5 studies showed that 6 amino acids were significantly increased in the cirrhotic group: Tyr, Met, Orn, Thr, Cit, and Trp, and 2 amino acids were significantly decreased: Arg and Val. At subgroup analysis, the combined results of Arg in serum of patients with hepatitis B cirrhosis were not statistically heterogeneity, and the remaining results in subgroup were similar to the primary results. Conclusions Alterations in serum amino acid profile were associated with cirrhosis. Some specific amino acids (Tyr, Met, Orn, Thr, Cit, Trp, Arg, and Val) may serve as biomarkers to predict cirrhosis.

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Section: Discussionsupporting

confidence: 74%

Predictive value of serum amino acids as metabolite biomarkers in cirrhosis: a systematic review and meta-analysis

Xiao

et al. 2023

Preprint

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“…Increased plasma nitrite/nitrate levels in individuals with decompensated cirrhosis are symptomatic of increased NO generation [15]. Cirrhosis cases and ascites had higher plasma RAAS activity and antidiuretic hormone levels, and a high serum NO level is related to reduced urine salt excretion as well as elevated plasma RAAS activity and antidiuretic hormone concentrations [15], [16].…”

Section: Discussionmentioning

confidence: 99%

Hepatorenal Syndrome: A Way for Early and Accurate Diagnosis

Aboul-Ezz¹,

Rahim

El-Mikkawy

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND: Hepatorenal syndrome (HRS) is a devastating consequence of liver cirrhosis that is clinically categorized into two subtypes. Acute malfunction of renal role, as measured by an elevation in blood creatinine, significantly underestimates the loss in renal function in cirrhotic individuals; more accurate biomarkers are desperately required in cirrhotic patients. AIM: The present study set out to uncover new biomarkers for the early prediction of AKI in cirrhotic cases. A comprehensive panel of biomarkers was investigated to get a clear insight into the pathogenesis of HRS. PATIENTS AND METHODS: Participants in this study were 70 individuals from the hepatogastroenterology unit of the Theodor Bilharz Research Institute (TBRI). Detailed medical data and a physical examination were recorded. Three groups of patients have been identified; Group 1: 30 cases with compensated liver cirrhosis and normal kidney functions. Group 2: 20 cases with decompensated liver cirrhosis and normal kidney functions. Group 3: 20 cases with decompensated liver cirrhosis proved hepatorenal syndrome Type 2 h. The following biomarkers were detected in serum using the sandwich-ELISA method: Human L-arginine ELISA kit, human neutrophil gelatinase related lipocalin (NGAL), human noradrenaline (NA), human asymmetrical dimethylarginine (ADMA), human symmetric dimethylarginine (SDMA), human nitric oxide (NO), and human renin. RESULTS: There was a highly significant difference between Groups 1 and 2 in NITRIC and ADMA. Significant differences between Groups 2 and 3 in NGAL, noradrenalin, and SDMA were observed. There was a significant difference (Group 2 vs. Group 3) in renin, NITRIC, ADMA, and L-ARGININE. There was highly significant differentiation (Group 2 vs. Group 3) in NGAL, noradrenalin, and SDMA. There was highly significant variation as per odd ratio and confidence interval between (Group 3 vs. Group 2) in NGAL. CONCLUSION: Assessment of renal biomarkers in individuals with decompensated cirrhosis gives critical information on the etiology of AKI. Further, it may aid in the diagnosis and prognosis of AKI. Renin, NITRIC, ADMA, and L-ARGININE could be used as biomarkers to indicate HRS in individuals with advanced cirrhosis.

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“…In another study involving liver transplant candidates, asymmetric dimethylarginine (ADMA) and NO levels were classified according to the SCORE index, and it was shown that they were significantly higher in the group with high CV risk. In the study, it was emphasized that the increase in ADMA and NO levels was independently associated with the increase in CV risk [ 23 ]. The authors, who integrated the PCE CV risk scoring system with isolated post-challenge hyperglycemia in postmenopausal women, created the opportunity to perform a more sensitive risk analysis on the participants with the modified assessment system they obtained [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

A New Marker for Determining Cardiovascular Risk: Salusin Alpha

Yılmaz¹,

Kurt²,

Aydin³

et al. 2022

Cureus

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Background and objectivePrevention of atherosclerotic cardiovascular diseases (ASCVD) is possible with early recognition of individuals at risk. Salusin alpha is an endogenous bioactive peptide with anti-atherogenic properties. We aimed to reveal the relationship between salusin alpha levels and cardiovascular (CV) risk using the Systematic COronary Risk Estimation 2 (SCORE2) and Pooled Cohort Equation (PCE) algorithms. MethodsA total of 137 asymptomatic outpatients were included in the study. The participants were divided into four quartile groups according to the distribution of salusin alpha levels: Q1 (n = 34), Q2 (n = 35), Q3 (n = 34), and Q4 (n = 34). The relationships of salusin alpha with cardiovascular risk scores and groups were investigated. ResultsThe means of SCORE2 and PCE risk scores (11.24 ± 1.24 and 13.30 ± 1.71, respectively; p < 0.001 for both), baseline scores in the presence of SCORE2 and PCE optimal risk factors (4.82 ± 0.71 (p = 0.034); 4.20 ± 0.77 (p = 0.010)), and means of Δ SCORE2 and Δ PCE risk score (6.41 ± 0.67 and 9.10 ± 1.10, respectively; p < 0.001 for both) were significantly higher in the Q1 group. The SCORE2 "very high" cardiovascular (CV) risk group was significantly represented in the Q1 group (n = 17 (50%)), while the "low-moderate" risk group was more heavily represented in the Q4 group (n = 15 (44.1%)) (p < 0.001). The PCE "high" CV risk group was significantly represented in the Q1 group (n = 9 (26.5%)), while the "low" risk group was more intensely represented in the Q4 group (n = 20 (58.8%)) (p < 0.001). Salusin alpha had a significantly negative moderate correlation with SCORE2 and PCE risk scores. As a result of receiver operating characteristic (ROC) analysis, it was found that salusin alpha had significant diagnostic power in the prediction of CV risk groups determined by SCORE2 and PCE risk scores. Salusin alpha was observed to be a risk-reducing factor in SCORE2 and PCE CV risk groups (odds ratio (OR) (95% confidence interval (CI)): 0.989 (0.982-0.997) (p = 0.002) and OR (95% CI): 0.988 (0.978-0.998) (p = 0.009) respectively). ConclusionSalusin alpha has a negative correlation with SCORE2 and PCE risk scores. It has significant diagnostic power in the prediction of CV risk groups and is an independent variable that has a risk-reducing effect in the distribution of risk groups.

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Association of Asymmetric Dimethylarginine and Nitric Oxide with Cardiovascular Risk in Patients with End-Stage Liver Disease

Cited by 4 publications

References 44 publications

Predictive value of serum amino acids as metabolite biomarkers in cirrhosis: a systematic review and meta-analysis

Predictive value of serum amino acids as metabolite biomarkers in cirrhosis: a systematic review and meta-analysis

Hepatorenal Syndrome: A Way for Early and Accurate Diagnosis

A New Marker for Determining Cardiovascular Risk: Salusin Alpha

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