The issue of plasma asymmetric dimethylarginine reference range - A systematic review and meta-analysis.
The issue of plasma asymmetric dimethylarginine reference range - A systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0177493
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Kiss I
中科院分区：
文献类型：
--
作者：
Németh B;Ajtay Z;Hejjel L;Ferenci T;Ábrám Z;Murányi E;Kiss I
不对称二甲基精氨酸(ADMA)是一氧化氮合酶的内源性抑制物，是内皮功能障碍的标志物和中介物。一些研究已经证明了它在心血管危险分层和全因死亡率预测中的价值。目的是确定健康成人血浆ADMA的参考范围。考虑到最广泛使用的ADMA测量方法，只登记了使用高效液相色谱(HPLC)-结合荧光或质谱仪检测-或酶联免疫吸附试验(ELISA)来定量血浆ADMA浓度的研究。66项研究被纳入定量分析(24项使用ELISA法，42项使用高效液相色谱法)，报告了5528名未服用任何药物的非糖尿病、非高血压、非肥胖成年人(男性3178人，女性2350人，年龄41.6±16.9岁)。高效液相色谱法测定ADMA的参考范围为0.34(0.29~0.38)~1.10(0.85~1.35)，平均值为0.71(0.57~0.85)(n=4093)；ELISA0.25(0.18~0.31)~0.92(0.76~1.09)，平均值为0.57(0.48~0.66)(n=1435)。大量文献表明，不对称二甲基精氨酸不仅是预测疾病结局的优秀工具，而且是一种新的潜在的治疗靶标物质；这种荟萃分析提供的参考范围将对进一步的研究具有重要意义和帮助。然而，制定一种标准的测量方法将有利于促进ADMA的临床应用。
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase, marker and mediator of endothelial dysfunction. Several studies have demonstrated its value in cardiovascular risk stratification and all-cause mortality prediction. The aim was to determine the reference range of plasma ADMA in healthy adults. Taking into account the most widely used ADMA measurement methods, only studies using either high performance liquid chromatography (HPLC) -with fluorescence or mass spectrometric detection-, or enzyme-linked immunosorbent assay (ELISA) to quantify plasma ADMA concentrations were enrolled. 66 studies were included in the quantitative analysis (24 using ELISA and 42 using HPLC) reporting a total number of 5528 non-diabetic, non-hypertensive, non-obese adults without any medication (3178 men and 2350 women, 41.6 ± 16.9 years old). The reference range of ADMA (in μmol/l with 95% confidence interval in parenthesis) was 0.34 (0.29–0.38)– 1.10 (0.85–1.35) with a mean of 0.71 (0.57–0.85) (n = 4093) measured by HPLC and 0.25 (0.18–0.31)– 0.92 (0.76–1.09) with a mean of 0.57 (0.48–0.66) (n = 1435) by ELISA. Numerous publications suggested that asymmetric dimethylarginine is not only an outstanding tool of disease outcome prediction but also a new potential therapeutic target substance; the reference range provided by this meta-analysis can become of great importance and aid to further investigations. However, developing a standard measurement method would be beneficial to facilitate the clinical usage of ADMA.