Symmetrical Dimethylarginine Predicts Mortality in the General Population Observations From the Dallas Heart Study
Symmetrical Dimethylarginine Predicts Mortality in the General Population Observations From the Dallas Heart Study
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DOI：
10.1161/atvbaha.113.301219
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发表时间：
2013-11-01
影响因子：
8.7
通讯作者：
Boeger, Rainer H.
中科院分区：
文献类型：
--
作者：
Gore, M. Odette;Lueneburg, Nicole;Boeger, Rainer H.
目的一氧化氮合酶抑制剂不对称二甲基精氨酸（ADMA）及其同源物对称二甲基精氨酸（SDMA）的升高可预测高危人群的心血管和全因死亡率。其在一般人群中的预后价值仍不确定。我们调查了SDMA和ADMA与动脉粥样硬化和心血管/全因死亡率的相关性，在达拉斯心脏研究，一个多种族的概率为基础的队列，年龄在30至65 years.Approach和Results SDMA和ADMA测定液相色谱-串联质谱（n=3523），冠状动脉钙电子束计算机断层扫描，和腹主动脉壁厚度MRI。在未校正的分析中，SDMA和ADMA增加的类别与心血管危险因素的患病率较高、风险标志物增加以及全因和心血管死亡率相关（中位随访时间为7.4年）。校正年龄、性别、种族、传统心血管危险因素和肾功能后，SDMA和ADMA作为连续变量分析与冠状动脉钙>10相关，但只有SDMA与腹主动脉壁厚度相关。SDMA而非ADMA与心血管死亡率相关（每对数单位变化的风险比，3.36 [95%置信区间，1.49-7.59]; P=0.004）。SDMA和ADMA均与全因死亡率相关，但在进一步校正N末端脑型利钠肽前体、高敏C反应蛋白和高敏心肌肌钙蛋白T后，只有SDMA与全因死亡率相关（每对数单位变化的风险比，1.86 [95%置信区间，1.04-3.30];结论在一个大型多种族人群队列中，SDMA是全因死亡率和心血管死亡率的独立预测因子，而ADMA不是。
Objective Increased asymmetrical dimethylarginine (ADMA), a NO synthase inhibitor, and its congener symmetrical dimethylarginine (SDMA), predict cardiovascular and all-cause mortality in at-risk populations. Their prognostic value in the general population remains uncertain. We investigated the correlations of SDMA and ADMA with atherosclerosis and cardiovascular/all-cause mortality in the Dallas Heart Study, a multiethnic probability-based cohort aged 30 to 65 years.Approach and Results SDMA and ADMA were measured by liquid chromatography-tandem mass-spectrometry (n=3523), coronary artery calcium by electron-beam computed tomography, and abdominal aortic wall thickness by MRI. In unadjusted analyses, categories of increasing SDMA and ADMA were associated with higher prevalence of cardiovascular risk factors, increased risk markers, and all-cause and cardiovascular mortality (median follow-up, 7.4 years). After adjustment for age, sex, and race, traditional cardiovascular risk factors, and renal function, SDMA and ADMA analyzed as continuous variables were associated with coronary artery calcium >10, but only SDMA was associated with abdominal aortic wall thickness. SDMA, but not ADMA, was associated with cardiovascular mortality (hazard ratio per log unit change, 3.36 [95% confidence interval, 1.49-7.59]; P=0.004). SDMA and ADMA were both associated with all-cause mortality, but after further adjustment for N-terminal pro-brain-type natriuretic peptide, high-sensitivity C-reactive protein, and high-sensitivity cardiac troponin T, only SDMA was associated with all-cause mortality (hazard ratio per log unit change, 1.86 [95% confidence interval, 1.04-3.30]; P=0.01).Conclusions SDMA, but not ADMA, was an independent predictor of all-cause and cardiovascular mortality in a large multiethnic population-based cohort.