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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Cardiovasc+Diabetol
2017 ; 16
(1
): 88
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
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.