Predictors of asymmetric dimethylarginine levels in patients with rheumatoid arthritis: the role of insulin resistance.

Abstract

OBJECTIVE:

To determine whether demographic, inflammatory, and metabolic factors predict elevated asymmetric dimethylarginine (ADMA) levels in rheumatoid arthritis (RA).

METHOD:

A total of 67 RA patients [mean age 56 ± 12 years, median disease duration 8 (3-15) years] were assessed. Routine biochemistry tests, lipid profile, glycaemic profile [glucose, insulin, homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI)], and inflammatory markers were measured in all patients. ADMA levels were measured by enzyme-linked immunosorbent assay (ELISA). Regression analyses were performed to identify predictors of ADMA in RA.

RESULTS:

Regression analysis revealed that HOMA (β = 0.149, p = 0.003) was an independent predictor of ADMA in RA. From the drug factors, anti-hypertensive medication use was associated with lower ADMA levels (β = -0.081, p = 0.004). ADMA was not associated with RA disease-related parameters or any of the other cardiovascular risk factors that were assessed.

CONCLUSIONS:

HOMA, a strong indicator of insulin resistance, seems to be the main predictor of elevated ADMA levels in RA patients; ADMA may reflect an important pathway linking abnormal insulin metabolism with endothelial dysfunction in RA.

• Authors: T Dimitroulas, A Sandoo, J J J C S Veldhuijzen van Zanten, J P Smith, J Hodson, G S Metsios, A Stavropoulos-Kalinoglou, G D Kitas
• Journal: Scandinavian journal of rheumatology (Scand J Rheumatol) Vol. 42 Issue 3 Pg. 176-81 ( 2013) ISSN: 1502-7732 [Electronic] England
• PMID: 23311682 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• N,N-dimethylarginine
• Arginine

Topics

• Adult
• Aged
• Arginine (analogs & derivatives, blood)
• Arthritis, Rheumatoid (blood)
• Female
• Homeostasis
• Humans
• Insulin Resistance
• Male
• Middle Aged