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10.1186/s12933-017-0569-8

http://scihub22266oqcxt.onion/10.1186/s12933-017-0569-8
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suck abstract from ncbi


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pmid28697799
      Cardiovasc+Diabetol 2017 ; 16 (1 ): 88
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  • Symmetric and asymmetric dimethylarginine as risk markers of cardiovascular disease, all-cause mortality and deterioration in kidney function in persons with type 2 diabetes and microalbuminuria #MMPMID28697799
  • Zobel EH ; von Scholten BJ ; Reinhard H ; Persson F ; Teerlink T ; Hansen TW ; Parving HH ; Jacobsen PK ; Rossing P
  • Cardiovasc Diabetol 2017[Jul]; 16 (1 ): 88 PMID28697799 show ga
  • BACKGROUND: To evaluate symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA) as risk markers of cardiovascular disease, all-cause mortality and deterioration in renal function in a well characterised type 2 diabetic population with microalbuminuria and without symptoms of coronary artery disease. METHODS: 200 participants followed for 6.1 years. SDMA and ADMA were measured at baseline. Endpoints included (1) composite cardiovascular endpoint (n = 40); (2) all-cause mortality (n = 26); and (3) decline in eGFR of >30% (n = 42). Cox models were unadjusted and adjusted for traditional risk factors (sex, age, systolic blood pressure, LDL-cholesterol, smoking, HbA(1c), creatinine and urinary albumin excretion rate). To assess if SDMA or ADMA improved risk prediction beyond traditional risk factors we calculated c statistics and relative integrated discrimination improvement (rIDI). C statistic (area under the curve) quantifies the model's improved ability to discriminate events from non-events. rIDI quantifies the increase in separation of events and non-events on a relative scale. RESULTS: Higher SDMA was associated with increased risk of all three endpoints (unadjusted: p ? 0.001; adjusted: p ? 0.02). Higher ADMA was associated with all-cause mortality (unadjusted: p = 0.002; adjusted: p = 0.006), but not cardiovascular disease or decline in eGFR (p ? 0.29).The c statistic was not significant for any of the endpoints for either SDMA or ADMA (p ? 0.10). The rIDI for SDMA was 15.0% (p = 0.081) for the cardiovascular endpoint, 52.5% (p = 0.025) for all-cause mortality and 48.8% (p = 0.007) for decline in eGFR; for ADMA the rIDI was 49.1% (p = 0.017) for all-cause mortality. CONCLUSION: In persons with type 2 diabetes and microalbuminuria higher SDMA was associated with incident cardiovascular disease, all-cause mortality and deterioration in renal function. Higher ADMA was associated with all-cause mortality. SDMA and ADMA significantly improved risk prediction for all-cause mortality, and SDMA for deterioration in renal function beyond traditional risk factors.
  • |Adult [MESH]
  • |Aged [MESH]
  • |Albuminuria/complications/diagnosis/*metabolism [MESH]
  • |Arginine/*analogs & derivatives/metabolism [MESH]
  • |Cardiovascular Diseases/blood/etiology/*mortality [MESH]
  • |Coronary Disease/diagnosis [MESH]
  • |Creatinine/metabolism [MESH]
  • |Diabetes Mellitus, Type 2/complications/diagnosis/*metabolism [MESH]
  • |Female [MESH]
  • |Glomerular Filtration Rate/physiology [MESH]
  • |Humans [MESH]
  • |Kidney/*physiopathology [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]


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