The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease

Abstract

Endothelium plays a crucial role in the maintenance of vascular tone and structure. Endothelial dysfunction is known to precede overt coronary artery disease. A number of cardiovascular risk factors, as well as metabolic diseases and systemic or local inflammation cause endothelial dysfunction. Nitric oxide (NO) is one of the major endothelium derived vaso-active substances whose role is of prime importance in maintaining endothelial homeostasis. Low levels of NO are associated with impaired endothelial function. Asymmetric dimethylarginine (ADMA), an analogue of L-arginine, is a naturally occurring product of metabolism found in human circulation. Elevated levels of ADMA inhibit NO synthesis and therefore impair endothelial function and thus promote atherosclerosis. ADMA levels are increased in people with hypercholesterolemia, atherosclerosis, hypertension, chronic heart failure, diabetes mellitus and chronic renal failure. A number of studies have reported ADMA as a novel risk marker of cardiovascular disease. Increased levels of ADMA have been shown to be the strongest risk predictor, beyond traditional risk factors, of cardiovascular events and all-cause and cardiovascular mortality in people with coronary artery disease. Interventions such as treatment with Larginine have been shown to improve endothelium-mediated vasodilatation in people with high ADMA levels. However the clinical utility of modifying circulating ADMA levels remains uncertain.

Metabolic profiling indicates impaired pyruvate dehydrogenase function in myalgic encephalopathy/chronic fatigue syndrome

“…In the present study, the mean serum level of the endogenous eNOS inhibitor and L-Arg analog ADMA was similar in ME/CFS patients and healthy controls. ADMA is usually elevated in cardiovascular endothelial dysfunction (50), indicating that the endothelial dysfunction mechanisms in ME/CFS, mainly affecting women of fertile age, differ from those in cardiovascular diseases.…”

Asymmetric Dimethylarginine Levels in Allergic Rhinitis and Nasal Polyposis

“…The relationship between the increase in ADMA levels and endothelial dysfunction has been established clearly. ADMA level has also been found to be influential in diabetes mellitus, chronic renal failure, metabolic syndrome, and Behçet's disease (14)(15)(16).…”

Aszimmetrikus dimetilarginin: a cardiovascularis betegségek prediktora?

“…Ezek tanulsága szerint az elhízott, hypertoniás, diabeteses, hypercholesterinaemiás, illetve dohányzó betegeknél a kontrollcsoporthoz képest magasabb az ADMA koncentrációja. Jellemzően emelkedett az ADMA szintje stroke-on átesett betegekben, végstádiumú veseelégte-lenségben és pangásos szívelégtelenségben szenvedőknél is [19][20][21].…”