Abstract 18233: Association of Circulating Levels of Asymmetric Dimethylarginine with Carotid Intima-Media Thickness: Evidence From 5269 Participants
Backgrounds: Epidemiologic investigations have linked the circulating levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase (NOS), to carotid intima-media thickness (IMT). However, these studies result in various extent of relation between ADMA and IMT, the conclusions were inconsistent, and the precise relationship is therefore under debate. The objective of this systematic review and meta-analysis is to provide an overview of the relevant studies evaluating the association of levels of ADMA with carotid IMT and to gain more robust estimate of the relationship.
Methods and results: Studies were identified through PubMed, Cochrane Library, Embase, reviews, and reference lists of relevant papers. Weighted mean differences (WMDs) of the correlation coefficient (R) and partial correlation coefficient (PR) were calculated for relations by using random-effect models. Eleven studies with a total of 5269 subjects were included in our meta-analysis. In an overall pooled estimate of correlation coefficient (R), levels of ADMA were significantly related to carotid IMT (pooled R: 0.25; 95% confidence interval [CI]: 0.146 to 0.363, P<0.001). Pooled estimate of partial correlation coefficient (PR) also resulted in a significant association of ADMA with carotid IMT (pooled PR: 0.15; 95% CI: 0.07 to 0.23; P <0.001). Furthermore, subgroup analysis found that the relation between ADMA and IMT was stronger in patients with Chronic Kidney Diseases (CKDs) than that in subject with normal renal function.
Conclusions: Circulating levels of ADMA were positively related to carotid IMT, especially in patients with CKDs. These findings indicate that elevation of plasma ADMA levels is an indicator of early-onset atherosclerosis and a predictor of atherosclerotic disease, especially in patients with CKDs. The findings of this meta-analysis need confirmation in longitudinal studies. Furthermore, future research efforts should be concentrated on higher quality, longer follow-up and more rigorous prospective and interventional studies to determine the causal relationships between the associations.
- © 2011 by American Heart Association, Inc.