Abstract 11432: Combined Elevations of Asymmetric Dimethylarginine and Homocysteine Have Big Impact on Carotid Atherosclerosis [[Unable to Display Character: —]] The Tanushimaru Study [[Unable to Display Character: —]]
Background: It is shown that elevated serum level of ADMA (asymmetric dimethylarginine) or homocystein (Hcy) is associated with atherosclerosis in humans. However, the impact of both elevations is not known. We investigated the combined elevations on the intima-media thickness (IMT) in a large number of subjects without overt cerebro-cardiovascular diseases by using carotid ultrasonography in a general population.
Methods: In 517 subjects (224 men, 293 women; mean age, 62.8 years) recruited from a population-based survey, we measured fasting plasma ADMA and Hcy levels, and performed bilateral carotid B-mode ultrasonography. The participants underwent measurements of other blood chemistries (total cholesterol, HDL-cholesterol, hemoglobin A1c, and creatinine). The presence of plaque was defined in the case of IMT>0.9mm by the guideline of ESH-ESC 2004.
Results: For the total population, the mean ADMA level was 0.49±0.13μmol/L and total Hcy level was 10.7±0.13μmol/L, respectively. With multiple linear regression analysis after adjustments for age and sex, ADMA levels were significantly related to Hcy (p<0.001), IMT(p<0.01),and systolic blood pressure (p<0.05). The IMT of high ADMA and high Hcy(n=147) was 0.76±0.22 mm versus 0.63±0.15 mm of low ADMA and low Hcy (n=157). Age and sex adjusted means of IMT were significantly higher (p<0.05) in the group of higher levels of ADMA and Hcy than in the group of lower levels of ADMA and Hcy. The relative risk of presence of plaque in the highest ADMA-Hcy group versus the lowest ADMA-Hcy group was 2.5 (p<0.01:95%C.I.; 1.066-5.709) by multiple logistic regression analysis adjusted for age, sex, and other confounders.
Conclusion: Our study indicates that combined elevations of plasma level of ADMA and Hcy have big impact on carotid atherosclerosis in a population of community-dwelling Japanese. This is the first report that the synergic effect on carotid atherosclerosis was demonstrated in the highest ADMA-Hcy group in an epidemiological study.
- © 2013 by American Heart Association, Inc.