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Serum metabolomic analysis of men on a low-carbohydrate diet for biochemically recurrent prostate cancer reveals the potential role of ketogenesis to slow tumor growth: a secondary analysis of the CAPS2 diet trial. Prostate Cancer Prostatic Dis 2022; 25:770-777. [PMID: 35338353 DOI: 10.1038/s41391-022-00525-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/16/2022] [Accepted: 03/02/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Systemic treatments for prostate cancer (PC) have significant side effects. Thus, newer alternatives with fewer side effects are urgently needed. Animal and human studies suggest the therapeutic potential of low carbohydrate diet (LCD) for PC. To test this possibility, Carbohydrate and Prostate Study 2 (CAPS2) trial was conducted in PC patients with biochemical recurrence (BCR) after local treatment to determine the effect of a 6-month LCD intervention vs. usual care control on PC growth as measured by PSA doubling time (PSADT). We previously reported the LCD intervention led to significant weight loss, higher HDL, and lower triglycerides and HbA1c with a suggested longer PSADT. However, the metabolic basis of these effects are unknown. METHODS To identify the potential metabolic basis of effects of LCD on PSADT, serum metabolomic analysis was performed using baseline, month 3, and month 6 banked sera to identify the metabolites significantly altered by LCD and that correlated with varying PSADT. RESULTS LCD increased the serum levels of ketone bodies, glycine and hydroxyisocaproic acid. Reciprocally, LCD reduced the serum levels of alanine, cytidine, asymmetric dimethylarginine (ADMA) and 2-oxobutanoate. As high ADMA level is shown to inhibit nitric oxide (NO) signaling and contribute to various cardiovascular diseases, the ADMA repression under LCD may contribute to the LCD-associated health benefit. Regression analysis of the PSADT revealed a correlation between longer PSADT with higher level of 2-hydroxybutyric acids, ketone bodies, citrate and malate. Longer PSADT was also associated with LCD reduced nicotinamide, fructose-1, 6-biphosphate (FBP) and 2-oxobutanoate. CONCLUSION These results suggest a potential association of ketogenesis and TCA metabolites with slower PC growth and conversely glycolysis with faster PC growth. The link of high ketone bodies with longer PSADT supports future studies of ketogenic diets to slow PC growth.
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Transport of L-Arginine Related Cardiovascular Risk Markers. J Clin Med 2020; 9:jcm9123975. [PMID: 33302555 PMCID: PMC7764698 DOI: 10.3390/jcm9123975] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022] Open
Abstract
L-arginine and its derivatives, asymmetric and symmetric dimethylarginine (ADMA and SDMA) and L-homoarginine, have emerged as cardiovascular biomarkers linked to cardiovascular outcomes and various metabolic and functional pathways such as NO-mediated endothelial function. Cellular uptake and efflux of L-arginine and its derivatives are facilitated by transport proteins. In this respect the cationic amino acid transporters CAT1 and CAT2 (SLC7A1 and SLC7A2) and the system y+L amino acid transporters (SLC7A6 and SLC7A7) have been most extensively investigated, so far, but the number of transporters shown to mediate the transport of L-arginine and its derivatives is constantly increasing. In the present review we assess the growing body of evidence regarding the function, expression, and clinical relevance of these transporters and their possible relation to cardiovascular diseases.
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Liffman R, Johnstone T, Tennent-Brown B, Hepworth G, Courtman N. Establishment of reference intervals for serum symmetric dimethylarginine in adult nonracing Greyhounds. Vet Clin Pathol 2018; 47:458-463. [DOI: 10.1111/vcp.12638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Rebekah Liffman
- Translational Research and Animal Clinical Trial Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Melbourne Vic. Australia
| | - Thurid Johnstone
- Translational Research and Animal Clinical Trial Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Melbourne Vic. Australia
| | - Brett Tennent-Brown
- Translational Research and Animal Clinical Trial Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Melbourne Vic. Australia
| | - Graham Hepworth
- Statistical Consulting Centre; The University of Melbourne; Parkville Vic. Australia
| | - Natalie Courtman
- Translational Research and Animal Clinical Trial Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Melbourne Vic. Australia
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Khajeh E, Panahi N, Golpaie A, Shirvani SH, Afarideh M, Ghamarnejad O, Talebpour M, Hosseinzadeh-Attar MJ. Plasma Apelin and Asymmetric Dimethylarginine (ADMA) Levels Shortly After Laparoscopic Greater Curvature Plication. Obes Surg 2016; 27:1596-1603. [PMID: 28013452 DOI: 10.1007/s11695-016-2509-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES We sought to investigate the short-term effect of weight loss following restrictive bariatric surgery on plasma concentrations of apelin and asymmetric dimethylarginine (ADMA) in individuals with morbid obesity. SUBJECTS/METHODS Thirty-seven morbidly obese individuals underwent laparoscopic greater curvature plication (LGCP). Anthropometric indices and plasma concentrations high-sensitivity C-reactive protein (hsCRP), apelin, and ADMA were measured before and 6 weeks after LGCP. RESULTS The percentage of total weight loss was 12.9 ± 4.4% 6 weeks after the operation. ADMA and apelin levels decreased significantly (p < 0.001 and 0.032, respectively) following LGCP. Significant decrements occurred in weight, body mass index, waist and hip circumference (p < 0.001), and waist-to-hip ratio (p = 0.013). The levels of triglycerides (p = 0.017), low-density lipoprotein cholesterol (p = 0.020), fasting plasma glucose (p = 0.033), fasting plasma insulin (p = 0.042), and the homeostasis model assessment index of insulin resistance (p = 0.034) also significantly decreased compared to the baseline measures. No significant change was observed in hsCRP levels and systolic and diastolic blood pressures. There was no significant correlation between changes in levels of apelin or ADMA and changes in anthropometric indices and other laboratory parameters. CONCLUSIONS Surgically induced weight loss rapidly decreases plasma levels of ADMA and apelin in morbidly obese patients. These changes do not seem correlated with changes in anthropometric and laboratory parameters associated with obesity.
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Affiliation(s)
- Elias Khajeh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nekoo Panahi
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Golpaie
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohsen Afarideh
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Ghamarnejad
- Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mohammad Talebpour
- Department of Surgery, Laparoscopic Surgical Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
Elevated plasma concentrations of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) are found in various clinical settings, including renal failure, coronary heart disease, hypertension, diabetes and pre eclampsia. In healthy people acute infusion of ADMA promotes vascular dysfunc tion, and in mice chronic infusion of ADMA promotes progression of atherosclerosis. Thus, ADMA may not only be a marker but also an active player in cardiovascular disease, which makes it a potential target for therapeutic interventions. This review provides a summary and critical discussion of the presently available data concern ing the effects on plasma ADMA levels of cardiovascular drugs, hypoglycemic agents, hormone replacement therapy, antioxidants, and vitamin supplementation. We assess the evidence that the beneficial effects of drug therapies on vascular func tion can be attributed to modification of ADMA levels. To develop more specific ADMA-lowering therapies, mechanisms leading to elevation of plasma ADMA con centrations in cardiovascular disease need to be better understood. ADMA is formed endogenously by degradation of proteins containing arginine residues that have been methylated by S-adenosylmethionine-dependent methyltransferases (PRMTs). There are two major routes of elimination: renal excretion and enzymatic degrada tion by the dimethylarginine dimethylaminohydrolases (DDAH-1 and -2). Oxidative stress causing upregulation of PRMT expression and/or attenuation of DDAH activity has been suggested as a mechanism and possible drug target in clinical conditions associated with elevation of ADMA. As impairment of DDAH activity or capacity is associated with substantial increases in plasma ADMA concentrations, DDAH is likely to emerge as a prime target for specific therapeutic interventions.
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Affiliation(s)
- Renke Maas
- Institute of Experimental and Clinical Pharmacology,
University Hospital Hamburg-Eppendorf, Hamburg, Germany
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6
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Affiliation(s)
- Jessica A. Hokamp
- Department of Veterinary Pathobiology; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX USA
| | - Mary B. Nabity
- Department of Veterinary Pathobiology; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station TX USA
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Abstract
The incidence of obesity is increasing at an alarming rate. There is compelling evidence that obesity increases the risk of preeclampsia about 3-fold, and in developed countries is the leading attributable risk for the disorder. In this presentation we explore this relationship and propose targets for future studies guided by the much more extensively studied relationship of obesity to cardiovascular disease. We further address the hypothesis that asymmetric dimethyl arginine (ADMA), an endogenous inhibitor of nitric oxide synthase, may be one convergence point for the mechanism by which obesity increases the risk of preeclampsia. We conclude with consideration of the clinical implications of this information.
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Mokhtari Z, Hosseini S, Miri R, Baghestani AR, Zahedirad M, Rismanchi M, Nasrollahzadeh J. Relationship between Dietary Approaches to Stop Hypertension score and Alternative Healthy Eating Index score with plasma asymmetrical dimethylarginine levels in patients referring for coronary angiography. J Hum Nutr Diet 2015; 28:350-6. [DOI: 10.1111/jhn.12311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Z. Mokhtari
- Department of Clinical Nutrition & Dietetics; Faculty of Nutrtiton Sciences and Food Technology; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - S. Hosseini
- Endocrinology and Metabolism Research Institute; Tehran University of Medical Sciences; Tehran Iran
| | - R. Miri
- Department of Cardiology; School of Medicine; Imam Hossein Hospital; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - A. R. Baghestani
- Department of Biostatistics; Faculty of Paramedical Sciences; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - M. Zahedirad
- Department of Nutrition Research; National Nutrition and Food Technology Research Institute; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - M. Rismanchi
- Faculty of Nutrition Sciences and Food Technology; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - J. Nasrollahzadeh
- Department of Clinical Nutrition & Dietetics; Faculty of Nutrition Sciences and Food Technology; National Nutrition and Food Technology Research Institute; Shahid Beheshti University of Medical Sciences; Tehran Iran
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Hall JA, Yerramilli M, Obare E, Yerramilli M, Jewell DE. Comparison of serum concentrations of symmetric dimethylarginine and creatinine as kidney function biomarkers in cats with chronic kidney disease. J Vet Intern Med 2014; 28:1676-83. [PMID: 25231385 PMCID: PMC4895610 DOI: 10.1111/jvim.12445] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 06/21/2014] [Accepted: 07/30/2014] [Indexed: 12/21/2022] Open
Abstract
Background Symmetric dimethylarginine (SDMA) has been shown to be an accurate and precise biomarker for calculating estimated glomerular filtration rate (GFR) in humans, as well as a more sensitive biomarker than serum creatinine concentration (sCr) for assessing renal dysfunction. Objectives The purpose of this retrospective study was to report on the utility of measuring serum SDMA concentrations in cats for detection of chronic kidney disease (CKD) before diagnosis by conventional measurement of sCr. Animals Chronic kidney disease cats (n = 21) included those persistently azotemic for ≥3 months (n = 15), nonazotemic cats with GFR >30% decreased from median GFR of normal cats (n = 4), and nonazotemic cats with calcium oxalate kidney stones (n = 2). Healthy geriatric cats (n = 21) were selected from the same colony. Methods Symmetric dimethylarginine concentrations (liquid chromatography‐mass spectroscopy) and sCr (enzymatic colorimetry) were determined retrospectively from historical data or banked serum samples in azotemic cats or at the time GFR (iohexol clearance) was measured in nonazotemic cats. Results Serum SDMA (r = −0.79) and sCr (r = −0.77) concentrations were significantly correlated to GFR (both P < .0001). Symmetric dimethylarginine became increased before sCr in 17/21 cats (mean, 17.0 months; range, 1.5–48 months). Serum SDMA had higher sensitivity (100%) compared with sCr (17%), but lower specificity (91% versus 100%) and positive predictive value (86% versus 100%). Conclusion and Clinical Importance Using serum SDMA as a biomarker for CKD allows earlier detection of CKD in cats compared with sCr, which may be desirable for initiating renoprotective interventions that slow progression of CKD.
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Affiliation(s)
- J A Hall
- Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR
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Teplan V, Mahrova A, Piťha J, Racek J, Gürlich R, Teplan Jr V, Valkovsky I, Štollova M. Early Exercise Training After Renal Transplantation and Asymmetric Dimethylarginine: The Effect of Obesity. Kidney Blood Press Res 2014; 39:289-98. [DOI: 10.1159/000355806] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 11/19/2022] Open
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Marchi KC, Muniz JJ, Tirapelli CR. Hypertension and chronic ethanol consumption: What do we know after a century of study? World J Cardiol 2014; 6:283-294. [PMID: 24944758 PMCID: PMC4062120 DOI: 10.4330/wjc.v6.i5.283] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 02/06/2023] Open
Abstract
The influences of life habits on the cardiovascular system may have important implications for public health, as cardiovascular diseases are among the leading causes of shorter life expectancy worldwide. A link between excessive ethyl alcohol (ethanol) consumption and arterial hypertension was first suggested early last century. Since then, this proposition has received considerable attention. Support for the concept of ethanol as a cause of hypertension derives from several epidemiologic studies demonstrating that in the general population, increased blood pressure is significantly correlated with ethanol consumption. Although the link between ethanol consumption and hypertension is well established, the mechanism through which ethanol increases blood pressure remains elusive. Possible mechanisms underlying ethanol-induced hypertension were proposed based on clinical and experimental observations. These mechanisms include an increase in sympathetic nervous system activity, stimulation of the renin-angiotensin-aldosterone system, an increase of intracellular Ca2+ in vascular smooth muscle, increased oxidative stress and endothelial dysfunction. The present report reviews the relationship between ethanol intake and hypertension and highlights some mechanisms underlying this response. These issues are of interest for the public health, as ethanol consumption contributes to blood pressure elevation in the population.
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Yousefi B, Faghfoori Z, Samadi N, Karami H, Ahmadi Y, Badalzadeh R, Shafiei-Irannejad V, Majidinia M, Ghavimi H, Jabbarpour M. The effects of Ramadan fasting on endothelial function in patients with cardiovascular diseases. Eur J Clin Nutr 2014; 68:835-9. [DOI: 10.1038/ejcn.2014.61] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/25/2014] [Accepted: 02/26/2014] [Indexed: 01/13/2023]
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Servillo L, Giovane A, Cautela D, Castaldo D, Balestrieri ML. The methylarginines NMMA, ADMA, and SDMA are ubiquitous constituents of the main vegetables of human nutrition. Nitric Oxide 2013; 30:43-8. [PMID: 23438481 DOI: 10.1016/j.niox.2013.02.080] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 02/05/2013] [Accepted: 02/08/2013] [Indexed: 01/16/2023]
Abstract
Endogenous methylarginines, N(G),N(G)-dimethyl-L-arginine (asymmetric dimethylarginine, ADMA), N(G)-N('G)-dimethyl-L-arginine (symmetric dimethylarginine; SDMA), and N(G)-monomethyl-L-arginine (monomethylarginine; NMMA) are supposed to be produced in human body through the methylation of protein arginine residues by protein arginine methyltransferases (PRMT) and released during proteolysis of the methylated proteins. Micromolar concentration of ADMA and NMMA can compete with arginine for nitric oxide synthase (NOS) reducing nitric oxide (NO) formation, whereas SDMA does not. Indeed, increased ADMA and SDMA plasma levels or a decreased arginine/ADMA ratio is related with risk factors for chronic kidney disease and cardiovascular disease. To the best of our knowledge the exogenous presence of methylarginines, like that in fruits and vegetables, has never been described so far. Here, we report the finding that methylarginines are ubiquitous in vegetables which represent an important part of human daily diet. Some of these vegetables contain discrete amounts of ADMA, SDMA, and NMMA. Specifically, among the vegetables examined, soybean, rye, sweet pepper, broad bean, and potato contain the highest ADMA and NMMA mean levels. Our results establish that the three methylarginines, in addition to being produced endogenously, can also be taken daily through the diet in conspicuous amounts. We propose that the contribution of the methylarginines contained in the vegetables of daily diet should be taken into account when the association between vegetable assumption and their levels is evaluated in clinical studies. Furthermore, a comprehensive understanding on the role of the digestive breakdown process and intestinal absorption grade of the methylarginines contained in vegetables is now needed.
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Affiliation(s)
- Luigi Servillo
- Dipartimento di Biochimica, Biofisica e Patologia Generale - Seconda Università degli Studi di Napoli, via L. De Crecchio 7, 80138 Naples, Italy.
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Lehtonen HM, Lindstedt A, Järvinen R, Sinkkonen J, Graça G, Viitanen M, Kallio H, Gil AM. 1H NMR-based metabolic fingerprinting of urine metabolites after consumption of lingonberries (Vaccinium vitis-idaea) with a high-fat meal. Food Chem 2012; 138:982-90. [PMID: 23411204 DOI: 10.1016/j.foodchem.2012.10.081] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 09/19/2012] [Accepted: 10/03/2012] [Indexed: 01/20/2023]
Abstract
The use of NMR metabolomics in clinical trials is growing; however, reports of postprandial experiments in humans are scarce. The present study investigated whether consumption of lingonberries as a supplement to an oil-rich meal modifies the postprandial fingerprints of human urine. Urine samples were analysed by (1)H NMR, and untargeted multivariate analysis was applied to the data for comprehensive fingerprinting. A clear separation of postprandial lingonberry meal samples was revealed. To evaluate statistical differences, a targeted approach was applied for the informative spectral areas. Significantly (p<0.05) increased levels of polyphenol metabolites, hippuric acid and 4-hydroxyhippuric acid, and decreased creatinine and dimethylamine levels were the major explanations for the grouping of the postprandial samples after the different meals. Thus, inclusion of polyphenol-rich lingonberry powder in a rapeseed oil-rich meal modifies the metabolic profile of urine which may be used to reveal both consumption of berries and health-promoting changes in the common metabolism.
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Affiliation(s)
- Henna-Maria Lehtonen
- Department of Biochemistry and Food Chemistry, University of Turku, FI-20014 Turku, Finland
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15
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Reduced plasma levels of asymmetric di-methylarginine (ADMA) in patients with alcohol dependence normalize during withdrawal. Eur Neuropsychopharmacol 2012; 22:836-40. [PMID: 22507687 DOI: 10.1016/j.euroneuro.2012.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 02/29/2012] [Accepted: 03/24/2012] [Indexed: 11/22/2022]
Abstract
Asymmetric di-methylarginine, an endogenous inhibitor of nitric oxide synthase, is increasingly recognized as vascular risk factor. Elevated ADMA levels have been described not only in 'typical' vascular diseases like congestive heart failure, artherosclerosis and diabetes but also for major depression and Alzheimer's disease. As homocysteine increases ADMA levels and elevated homocysteine serum levels are present in patients with alcohol dependence, the aim of the present study was to examine plasma ADMA levels in patients with alcohol dependence during withdrawal. ADMA and homocysteine levels were measured in the plasma from 42 patients drawn at baseline, on day 1, day 3 and day 7-10 of inpatient detoxification treatment. Measurements were compared against 32 healthy controls. We found significantly lower levels of ADMA in patients at baseline and on day 1 and 3, while no differences were present at the end of treatment. Plasma ADMA levels significantly increased during withdrawal. We found no association between homocysteine and ADMA levels. Our finding of reduced ADMA levels in actively drinking alcohol dependent patients is in apparent contrast to other findings regarding cardiovascular risk factors in alcoholism. However an influence of alcohol on arginine metabolism may help explain the so called 'French paradox'.
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Engeli S, Tsikas D, Lehmann AC, Böhnke J, Haas V, Strauß A, Janke J, Gorzelniak K, Luft FC, Jordan J. Influence of dietary fat ingestion on asymmetrical dimethylarginine in lean and obese human subjects. Nutr Metab Cardiovasc Dis 2012; 22:720-726. [PMID: 21420841 DOI: 10.1016/j.numecd.2011.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 12/14/2010] [Accepted: 01/03/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Asymmetrical dimethylarginine (ADMA) may contribute to hypertension and cardiovascular disease by decreasing NO formation. In diabetic patients, a high fat meal acutely increased plasma ADMA while impairing endothelial function. We hypothesized that chronic and acute increases in dietary fat intake augment ADMA also in lean and in obese subjects without diabetes. METHODS AND RESULTS Seventeen lean and twelve obese volunteers were randomized to two weeks of isocaloric diets with approximately 20% or >40% calories from fat in a cross-over fashion. At the end of the high and low fat periods, volunteers received corresponding test meals. ADMA was measured by GC-MS/MS using a deuterated standard. Mean fasting plasma ADMA concentration was 0.52 (0.49-0.54; 95% CI) μmol/l in lean and 0.53 (0.50-0.55) μmol/l in obese subjects (p = 0.55). The two week high fat diet did not influence ADMA. Both test meals elicited a 6%increase in circulating ADMA in lean subjects. In obese subjects, plasma ADMA concentration did not change with the low fat meal, and decreased by approximately 4% with the high fat meal. CONCLUSION Our findings challenge the idea that obesity and dietary fat intake have a major effect on plasma ADMA, at least in subjects without overt cardiovascular and metabolic disease. This finding is important with regard to dietary recommendations for weight loss. Overestimation of the influence of dietary fat intake and obesity on circulating ADMA in previous reports was most likely due to methodological issues concerning ADMA measurements.
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Affiliation(s)
- S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Strasse1, 30625 Hannover, Germany.
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Goralczyk T, Tisonczyk J, Fijorek K, Undas A. High tea and vegetable consumption is associated with low ADMA generation in older healthy subjects. Metabolism 2012; 61:1171-6. [PMID: 22386943 DOI: 10.1016/j.metabol.2011.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 12/21/2011] [Accepted: 12/29/2011] [Indexed: 12/31/2022]
Abstract
Asymmetric dimethylarginine (ADMA) has been recognized as a marker of cardiovascular risk. We sought to investigate whether consumption of tea, coffee, fruit or vegetables is associated with ADMA. In 148 consecutive apparently healthy subjects (104 men and 44 women aged 40 to 70), daily tea, coffee, fruit and vegetable consumption was ascertained by questionnaire. Plasma ADMA, symmetric dimethylarginine (SDMA), and l-arginine levels were measured by high-performance liquid chromatography. Median tea and coffee consumption was 2 cups/d, while vegetable and fruit intake was 152 (120-179)g/d and 120 (108-134)g/d, respectively. Median plasma ADMA, SDMA and arginine were 0.47 (0.43-0.53)μmol/L, 0.59 (0.54-0.66)μmol/L and 86 (68-101)μmol/L, respectively. ADMA correlated inversely with tea (r = -0.70, P < .0001) and vegetable consumption (r = -0.50, P < .0001) even after adjustment for age, sex, body mass index, smoking status, and potential dietary and biochemical parameters. No association between ADMA and fruit consumption was found. ADMA correlated positively with coffee intake (r = 0.37, P < .0001), although these associations were less potent after adjustment for dietary factors. Higher tea and vegetable intake is associated with lower plasma ADMA levels in healthy middle-aged subjects.
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Teplan V, Vyhnánek F, Gürlich R, Haluzík M, Racek J, Vyhnankova I, Stollová M, Teplan V. Increased proinflammatory cytokine production in adipose tissue of obese patients with chronic kidney disease. Wien Klin Wochenschr 2010; 122:466-73. [PMID: 20658196 DOI: 10.1007/s00508-010-1409-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Accepted: 04/29/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND Obesity is a known high-risk factor for the development of vascular diseases and chronic kidney disease (CKD). In this study we aimed to elucidate the impact of adipose tissue on the inflammatory state in CDK patients with obesity. PATIENTS AND METHODS A cohort of 40 patients with CKD (stages 3-4) with mild proteinuria (2.3-3.5 g/day) were analyzed in a prospective cross-sectional study: single blood samples and visceral and subcutaneous samples of adipose tissue were taken from 20 patients with obesity and 20 without obesity (control group) during elective abdominal surgery (laparoscopic cholecystectomy). Serum concentrations of asymmetric dimethylarginine (ADMA), adiponectin, C-reactive protein, interleukin-6, tumor necrosis factor-alpha, pentosidine and monocyte chemoattractant protein-1 were measured. Messenger RNA expression of tumor necrosis factor-alpha, monocyte chemoattractant protein-1, adiponectin receptors 1 and 2, and immunocompetent cell marker CD68 was measured in subcutaneous and visceral fat samples using real-time PCR. Adipose tissue was examined immunohistochemically for CD68-positive cells. Other biochemical parameters (insulin, glycated hemoglobin, cholesterol, LDL cholesterol, and triglycerides) were assessed in the two groups of patients at the same time. RESULTS Serum concentrations of ADMA, C-reactive protein, pentosidine, interleukin-6, tumor necrosis factor-alpha and monocyte chemoattractant protein-1 were significantly higher in obese CKD patients than in the control group; adiponectin was lower in the obese group. Subcutaneous and visceral mRNA expressions of tumor necrosis factor-alpha, CD68, adiponectin receptor-1, and monocyte chemoattractant protein-1 were significantly increased in the obese patients, whereas expression of adiponectin, interleukin-6, and adiponectin receptor-2 did not significantly differ between the patient groups. In general, mRNA expressions were higher in visceral than in subcutaneous samples (P < 0.01 vs. P < 0.05). Increased infiltration of subcutaneous and visceral adipose tissue by CD68-positive immunocompetent cells was found in the obese CKD group. With respect to lipid metabolism parameters, a small but significant increase in levels was found in the obese patients (P < 0.02). Changes in triglycerides were more marked in this group (P < 0.01) and a similar increase was noted in insulin and HbA1c levels (P < 0.02). CONCLUSION Increased expression of proinflammatory cytokines and increased infiltration by immunocompetent cells were found in adipose tissue of obese patients with CKD stages 3-4. This upregulated inflammation may contribute to the induction of a systemic proinflammatory state in patients with CKD and could accelerate the progression of renal dysfunction.
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Affiliation(s)
- Vladimír Teplan
- Department of Surgery, Charles University, Prague, Czech Republic.
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Toda N, Ayajiki K. Vascular actions of nitric oxide as affected by exposure to alcohol. Alcohol Alcohol 2010; 45:347-55. [PMID: 20522422 DOI: 10.1093/alcalc/agq028] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vasodilator substances liberated from endothelial cells, mainly nitric oxide (NO), play important roles in physiologically regulating blood flow and blood pressure and preventing pathological vascular damage. Impairment of these actions promotes the genesis of cardiovascular diseases such as hypertension, cerebral and cardiac hypoperfusion, impaired vasodilatation and atherosclerosis. Low concentrations of alcohol induce increased release of NO from the endothelium due to activation and expression of NO synthase (NOS). In contrast, administration of high concentrations of alcohol or its chronic ingestion impairs endothelial functions in association with reduced NO bioavailability. The endogenous NOS inhibitor asymmetric dimethylarginine may participate in decreased synthesis of NO. Chronic alcohol intake also impairs penile erectile function possibly by interfering with endothelial, but not nitrergic nerve, function. This review article summarizes the vascular actions of NO derived from endothelial and neuronal NOS as affected by alcohol, other than wine, and acetaldehyde in healthy individuals, human materials and various experimental animals.
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Affiliation(s)
- Noboru Toda
- Toyama Institute for Cardiovascular Pharmacology Research, 7-13, 1-Chome, Azuchi-machi, Chuo-ku, Osaka 541-0052, Japan.
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Teplan V, Schück O, Racek J, Mareckova O, Stollova M, Hanzal V, Malý J. Reduction of plasma asymmetric dimethylarginine in obese patients with chronic kidney disease after three years of a low-protein diet supplemented with keto-amino acids: a randomized controlled trial. Wien Klin Wochenschr 2009; 120:478-85. [PMID: 18820852 DOI: 10.1007/s00508-008-0987-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2007] [Accepted: 05/15/2008] [Indexed: 01/13/2023]
Abstract
BACKGROUND Levels of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) are elevated in chronic kidney disease (CKD) and may contribute to vascular complications. In this study we tested the hypothesis that elevated ADMA can be reduced in obese CKD patients by long-term administration of a low-protein diet supplemented with keto-amino acids. PATIENTS AND METHODS In a long-term prospective double-blind placebo-controlled randomized trial, we evaluated for a period of 36 months a total of 111 CKD patients (54 men, 57 women) aged 22-76 years with obesity (BMI >or= 30 kg/m(2)) and an inulin clearance rate (C(in)) of 22-40 ml/min/1.73 m(2). All patients were on a low-protein diet containing 0.6 g protein/kg BW per day and 120-125 kJ/kg BW per day. The diet was randomly supplemented with keto-amino acids at a dosage of 100 mg/kg BW per day (66 patients, Group I); 65 patients received placebo (Group II). RESULTS During the study period, the glomerular filtration rate decreased slightly in Group I (C(in) from 32.4 +/- 12.6 to 29.8 +/- 8.6 ml/min/1.73 m(2)) and more markedly in Group II (from 33.2 +/- 12.6 to 23.2 +/- 98.4 ml/min/1.73 m(2), P < 0.01). BMI decreased significantly in Group I (from 32.0 +/- 3.3 to 26.1 +/- 4.0 kg/m(2), P < 0.01) and was linked to reduced volume of visceral fat measured by MRI (P < 0.01). Reduction of BMI in Group II was not significant. In Group I, there was a significant decrease in the plasma level of ADMA (from 2.5 +/- 0.5 to 1.3 +/- 0.4 micromol/l, P < 0.01), but ADMA remained unchanged in Group II. A further remarkable finding in Group I was reduction in the plasma concentration of pentosidine (from 480 +/- 170 to 320 +/- 120 microg/l, P < 0.01) and decrease of proteinuria (from 3.8 +/- 2.24 to 1.6 +/- 1.0 g/24 h, P < 0.02). Plasma adiponectin rose in Group I (P < 0.01). Analysis of the lipid spectrum revealed a mild but significant decrease in total cholesterol and LPD-cholesterol (P < 0.02), more pronounced in Group I. There was also a decrease in plasma triglycerides in Group I (from 3.9 +/- 1.6 down to 2.2 +/- 0.6 mmol/l, P < 0.01) and a decrease in glycated hemoglobin (from 7.2 +/- 1.4% to 4.2 +/- 0.8%, P < 0.02). CONCLUSION Compared with the placebo group, long term co-administration of a low-protein diet and keto-amino acids in CKD patients with obesity led to decreases of ADMA, visceral body fat and proteinuria. Concomitant decreases of glycated hemoglobin, LDL-cholesterol and pentosidine may also contribute to the delay in progression of renal failure.
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Affiliation(s)
- Vladimir Teplan
- Department of Nephrology, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
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Wu CC, Wen SC, Yang CW, Pu SY, Tsai KC, Chen JW. Plasma ADMA predicts restenosis of arteriovenous fistula. J Am Soc Nephrol 2008; 20:213-22. [PMID: 19118151 DOI: 10.1681/asn.2008050476] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Plasma levels of asymmetrical dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide production, correlate with endothelial dysfunction and the development of cardiovascular events in patients with uremia. It is not known whether endothelial dysfunction contributes to the dysfunction of arteriovenous fistulas (AVFs) in hemodialysis patients. Here, we studied the predictive value of baseline plasma ADMA for symptomatic restenosis of an AVF after percutaneous transluminal angioplasty in dialysis patients. We obtained baseline plasma ADMA levels before percutaneous transluminal angioplasty in 100 consecutive patients with dysfunctional AVFs. Patients were followed up clinically for up to 6 mo after angioplasty for recurrent dysfunction. During the 6 mo after angioplasty, 46 patients experienced recurrent dysfunction of their AVF; of these, follow-up fistulography showed restenosis at the same location in 41, new stenosis at different locations in two, and no significant stenosis in three patients. Up to 60% of the patients with high levels of ADMA (>0.910 microM) had target lesion restenosis compared with 25% of those with low levels (<0.910 microM; P < 0.001). In multivariate analysis, plasma ADMA independently nearly tripled the risk for recurrent symptomatic stenosis of an AVF after percutaneous transluminal angioplasty (hazard ratio 2.65; 95% confidence interval 1.33 to 5.28). These results suggest a role for ADMA in the progression of symptomatic restenoses of AVFs after percutaneous transluminal angioplasty and call for preventive strategies that target ADMA and/or endothelial dysfunction to decrease the risk for AVF restenosis.
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Affiliation(s)
- Chih-Cheng Wu
- Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec.2, Shih-Pai Road, Taipei, Taiwan, Republic of China
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Teplan V, Schück O, Racek J, Lecian D, Haluzik M, Kudla M, Vitko S. Asymmetric Dimethylarginine in Obesity After Renal Transplantation. J Ren Nutr 2008; 18:513-20. [DOI: 10.1053/j.jrn.2008.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Indexed: 02/01/2023] Open
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Paiva H, Kahonen M, Lehtimaki T, Raitakari OT, Jula A, Viikari J, Alfthan G, Juonala M, Laaksonen R, Hutri-Kahonen N. Asymmetric dimethylarginine (ADMA) has a role in regulating systemic vascular tone in young healthy subjects: the cardiovascular risk in young Finns study. Am J Hypertens 2008; 21:873-8. [PMID: 18551100 DOI: 10.1038/ajh.2008.215] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study was designed to evaluate whether plasma asymmetric dimethylarginine (ADMA) has any role in predicting hemodynamic responses in clinically healthy young subjects. ADMA, as an endogenous nitric oxide (NO) synthase inhibitor, has been demonstrated to associate with hypertension and vascular reactivity in experimental but not undoubtedly in physiological settings. METHODS A total of 199 subjects aged 31.4 years (range 24-39 years) were studied. Plasma ADMA and symmetric dimethylarginine (SDMA) were assessed by isocratic high-pressure liquid chromatography using precolumn derivatization with o-phtaldialdehyde at baseline. Blood pressure (BP) was measured by casual measurements in the beginning of the study and after a follow-up period of 2.45 +/- 0.42 years (range, 1.86-3.19 years). Hemodynamic regulation was assessed by noninvasive methods after a follow-up. RESULTS Plasma ADMA had a negative association with resting systemic vascular resistance index (SVRI) (r = -0.23, P < 0.01) and pulse wave velocity (PWV) (r = -0.17, P < 0.05) and positive association with cardiac index (CI) (r = 0.21, P < 0.01) after the follow-up. Plasma ADMA had also negative association with responses of SVRI (r = -0.19, P < 0.01) and positive association with CI (r = 0.25, P < 0.001) in a hemodynamic reactivity test. In a multivariate linear model (R2 = 0.20, P < 0.00001), diastolic BP (R = 0.37, P < 0.00001) and ADMA (R = -0.20, P < 0.01) were significant predictors of SVRI. CONCLUSIONS These results suggest that plasma ADMA seems to play a role in the regulation of vascular tone in young healthy subjects.
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Abstract
Elevated plasma concentrations of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) are found in various clinical settings, including renal failure, coronary heart disease, hypertension, diabetes and pre-eclampsia. In healthy people acute infusion of ADMA promotes vascular dysfunction, and in mice chronic infusion of ADMA promotes progression of atherosclerosis. Thus, ADMA may not only be a marker but also an active player in cardiovascular disease, which makes it a potential target for therapeutic interventions. This review provides a summary and critical discussion of the presently available data concerning the effects on plasma ADMA levels of cardiovascular drugs, hypoglycemic agents, hormone replacement therapy, antioxidants, and vitamin supplementation. We assess the evidence that the beneficial effects of drug therapies on vascular function can be attributed to modification of ADMA levels. To develop more specific ADMA-lowering therapies, mechanisms leading to elevation of plasma ADMA concentrations in cardiovascular disease need to be better understood. ADMA is formed endogenously by degradation of proteins containing arginine residues that have been methylated by S-adenosylmethionine-dependent methyltransferases (PRMTs). There are two major routes of elimination: renal excretion and enzymatic degradation by the dimethylarginine dimethylaminohydrolases (DDAH-1 and -2). Oxidative stress causing upregulation of PRMT expression and/or attenuation of DDAH activity has been suggested as a mechanism and possible drug target in clinical conditions associated with elevation of ADMA. As impairment of DDAH activity or capacity is associated with substantial increases in plasma ADMA concentrations, DDAH is likely to emerge as a prime target for specific therapeutic interventions.
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Affiliation(s)
- Renke Maas
- Institute of Experimental and Clinical Pharmacology, University Hospital Hamburg-Eppendorf, Germany.
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Haider DG, Bucek RA, Reiter M, Minar E, Hron G, Kyrle PA, Mittermayer F, Wolzt M. The cardiovascular risk marker asymmetrical dimethylarginine is not affected by venous thromboembolism. Transl Res 2006; 148:26-9. [PMID: 16887495 DOI: 10.1016/j.lab.2006.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2005] [Revised: 03/15/2006] [Accepted: 03/16/2006] [Indexed: 10/24/2022]
Abstract
Asymmetrical dimethylarginine (ADMA) is an endogenous inhibitor of endothelial nitric oxide synthase, causes vasoconstriction, impairs cardiac function, and may predict cardiovascular risk. The prognostic value of plasma ADMA concentrations in acute vascular situations may be confounded by concomitant factors such as clot formation. In an effort to address the effect of hemostatic system activation, the authors have measured plasma concentrations of ADMA, its stereoisomer symmetrical dimethylarginine (SDMA), and L-arginine in 74 patients with suspected deep vein thrombosis (DVT). DVT was confirmed by sonography or venography in 39 subjects. There was no difference of L-arginine, ADMA, or SDMA (all P > 0.05) between subjects with or without DVT. ADMA correlated with SDMA, L-arginine, and plasma creatinine (all P < 0.05) but not with age, body mass index, D-dimer, thrombus extension, or history of symptoms. Venous thrombembolism does not influence circulating ADMA concentrations. The lack of association between ADMA and DVT argues against a contribution of endogenous NO synthase inhibition in hemostatic systemic activation.
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Affiliation(s)
- Dominik G Haider
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Busch M, Fleck C, Wolf G, Stein G. Asymmetrical (ADMA) and symmetrical dimethylarginine (SDMA) as potential risk factors for cardiovascular and renal outcome in chronic kidney disease - possible candidates for paradoxical epidemiology? Amino Acids 2006; 30:225-32. [PMID: 16680555 DOI: 10.1007/s00726-005-0268-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Accepted: 11/25/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Asymmetrical dimethylarginine (ADMA) is an inhibitor of nitric-oxide synthase. It has been linked to atherosclerotic risk in the general population as well as in end-stage renal disease patients (ESRD), whereas symmetrical dimethylarginine (SDMA) is thought to be biological inactive. Prospective data concerning the role of both dimethylarginines are rare in patients with chronic kidney disease. METHODS 200 Patients with chronic kidney disease (mean age 57.6 +/- 13.0 years, 69 female, 131 male); 82 with chronic renal failure (CRF), 81 on maintenance haemodialysis (HD) and 37 renal transplant recipients (RTR) were prospectively followed for 24 months. ADMA and SDMA were measured by HPLC. The relation of plasma levels of ADMA and SDMA together with conventional risk factors for the cardiovascular and renal outcome was investigated with Cox proportional hazards model. RESULTS Mean serum levels of SDMA were significantly increased in all groups compared to the control group (P <or= 0.0005), ADMA was increased only in HD and RTR (P <or= 0.004). Forty-seven cardiovascular events (CVE) occurred during follow-up, 35 patients died, and 39 patients reached ESRD. Multivariate analysis showed diabetes (RR 3.072, P = 0.01), ESRD (RR 11.915, P < 0.0005), elevated CRP levels (RR 3.916, P < 0.0005) and surprisingly a lower ADMA level (RR 0.271, P = 0.008) as independent risk factors for CVE. Serum creatinine (RR 11.378, P = 0.001), haemoglobin (RR 0.710, P = 0.038 for an increment of 1 mmol/l), and SDMA levels (RR 1.633, P = 0.006, per 1 micromol/l increment) were predictors for the progression to ESRD. CONCLUSIONS Data from a heterogeneous group of patients with chronic kidney disease provide evidence that conventional risk factors seem to play a more important role than elevated serum levels of ADMA or SDMA for cardiovascular events. Increasing serum SDMA concentration seems to play an additive role for the renal outcome besides serum creatinine and haemoglobin levels. Whether ADMA might possibly be a candidate for the phenomenon of "paradoxical epidemiology" in chronic kidney disease needs further investigation.
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Affiliation(s)
- M Busch
- Department of Internal Medicine III, University of Jena, Jena, Germany.
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Marliss EB, Chevalier S, Gougeon R, Morais JA, Lamarche M, Adegoke OAJ, Wu G. Elevations of plasma methylarginines in obesity and ageing are related to insulin sensitivity and rates of protein turnover. Diabetologia 2006; 49:351-9. [PMID: 16369774 DOI: 10.1007/s00125-005-0066-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Accepted: 08/30/2005] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS Increased circulating methylarginines (MA) have been linked to the metabolic syndrome to explain endothelial dysfunction and cardiovascular disease risk. Proteins that contain MA are regulatory and release them during catabolism. We hypothesised that increased protein turnover in insulin-resistant states contributes to an increase in circulating MA. MATWERIALS AND METHODS: We performed hyperinsulinaemic, euglycaemic, and isoaminoacidaemic experiments on 49 lean, obese and elderly subjects, with measurements of the kinetics of glucose and protein metabolism. Plasma MA, i.e. asymmetrical dimethylarginine (ADMA), symmetrical dimethylarginine (SDMA), and N -monomethyl-L-arginine (NMMA), lipids and body composition were measured. RESULTS Insulin resistance of glucose and protein metabolism occurred in obese and elderly subjects. ADMA concentrations were 29 to 120% higher in obese and 34% higher in elderly than in lean subjects. SDMA were 34 and 20% higher in obese than in lean and than in elderly subjects, respectively. NMMA were 32% higher in obese than in lean subjects. ADMA differed by sex, being higher in men, namely by 1.75x in obese men and by 1.27x in elderly men. Postabsorptive ADMA (r=0.71), SDMA (r=0.46), and NMMA (r=0.31) correlated (all p<0.05) with rates of protein flux. All three MA correlated negatively with clamp glucose infusion rates and uptake (p<0.001). ADMA and SDMA correlated negatively with net protein synthesis and clamp amino acid infusion rates (p<0.05). All MA also correlated with adiposity indices and fasting insulin and triglycerides (p<0.05). CONCLUSIONS/INTERPRETATION Obesity, sex and ageing affect MA. Elevations of the three MA in obese, and of ADMA in elderly men, are related to increased protein turnover and to lesser insulin sensitivity of protein metabolism. These interrelationships might amplify insulin resistance and endothelial dysfunction.
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Affiliation(s)
- E B Marliss
- McGill Nutrition and Food Science Centre, MUHC-Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada.
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