Correlation Study Of Homocysteine, Nitric Oxide And Asymmetric Dimethylarginine Among Maintenance Hemodialysis Patients

Objective:Detect the levels of serum urea(UREA), creatinine （CREA），homocysteine (Hcy), Nitric oxide (NO) and asymmetric dimethylarginine(ADMA) in maintenance hemodialysis (MHD). Explore the influences ofhemodialysis on serum Hcy, serum NO, serum ADMA and analysis theircorrelation.Method：1. The Study Object:1.1control group:22healthy cases(males13cases, females9cases), age25-73years, average age47.95±16.27years who had the physicalexamination in the Second Hospital of Hebei Medical University.1.2uremia group(Non-dialysis):22cases(males12cases, females10cases),age23-76years, average age45.54±15.51years, who had been treated in theSecond Hospital of Hebei Medical University from March2011to March2012.1.3maintenance hemodialysis group:22cases(males11cases, females11cases), age22-78years, average age48.77±18.45years, who had beendiagnosed as uremia and been treated with hemodialysis more than threemonths in the Second Hospital of Hebei Medical University.2outcome measures: name, gender, age, height, weight, course, Hemodialysistime, ultrafiltration volume, blood pressure, heart rate, primary disease, urinevolume, serum UREA, CREA, Hcy, NO, ADMAetc.Results:1The general information(age, sex) of the three groups: There were notsignificant differences in age, sex among the groups.2The renal function of the three groups: The serum UREA level of thecontrol group was5.19±0.95mmol/L, the serum CREA level was83.95± 12.74μmol/L, and the serum β2MG level was1.34±0.62μmol/L. Theserum UREA level of the uremia(Non-dialysis) group was24.85±6.23mmol/L, the serum CREA level was798.59±214.56μmol/L, and theserum β2MG level was16.58±3.60mol/L. The serum UREA level of themaintenance hemodialysis group(before hemodialysis) was28.57±7.67mmol/L, the serum CREA level was898.50±243.90μmol/L, and theserum β2MG level was16.58±3.60μmol/L. The serum UREA level of themaintenance hemodialysis group(after hemodialysis) was10.46±4.06mmol/L,the serum CREA level was405.39±142.07μmol/L, and the serum β2MGlevel was15.70±2.23mol/L. After the statistical analysis, the level of serumUREA, CREA, β2MG in the uremic(Non-dialysis) group and themaintenance hemodialysis(before and after) group were higher than those inthe healthy control group, and the difference was statistically significant (P<0.01). The level of serum UREA(P>0.05), CREA(P<0.01), β2MG(P>0.05)in the maintenance hemodialysis(before) group were higher than those in theuremic(Non-dialysis) group. The level of serum UREA, CREA in themaintenance hemodialysis(after) group were lower than those in themaintenance hemodialysis(before) group, and the difference was statisticallysignificant (P <0.01).3The comparison of serum Hcy and serum NO level of the three groups:The serum Hcy level of the control group was8.21±1.55μmol/L, the serumNO level was45.97±13.36μmol/L, the serum ADMA level was0.34±0.14μmol/L. The serum Hcy level of the uremia(Non-dialysis) group was45.57±14.40μmol/L, the serum NO level was151.37±54.70μmol/L, the serumADMA level was0.89±0.18μ mol/L. The serum Hcy level of themaintenance hemodialysis(before) group was30.80±2.36μmol/L, the serumNO level was144.12±76.72μmol/L, the serum ADMA level was0.89±0.24μmol/L. The serum Hcy level of the maintenance hemodialysis(after) groupwas19.31±1.63μmol/L, the serum NO level was59.97±27.61μmol/L, theserum ADMA level was0.60±0.39μmol/L. After the statistical analysis, thelevel of serum Hcy, NO in the uremic(Non-dialysis) group and the maintenance hemodialysis(before and after) group were higher than those inthe healthy control group, and the difference was statistically significant (P<0.01). The level of serum Hcy(P<0.05), Hcy(P>0.05) in the maintenancehemodialysis(before) group were higher than those in the uremic(Non-dialysis)group. The level of serum Hcy, NO in the maintenance hemodialysis(after)group were lower than those in the maintenance hemodialysis(before) group,and the difference was statistically significant (P <0.01).4The correlation analysis on serum Hcy and age, serum NO, serumADMA of the three groups: serum Hcy had no significant correlation withage(r=-0.06，P>0.05), NO (r=-0.33，P>0.05) in the healthy control group, hadpositive significant correlation with serumADMA（r=0.62，P<0.01）. SerumHcy had no significant correlation with age(r=0.23，P>0.05), NO (r=0.18，P>0.05) in the uremia(Non-dialysis) group, had positive significant correlationwith serum ADMA（r=0.79，P<0.01）. Serum Hcy had no significantcorrelation with age(r=-0.13， P>0.05), NO (r=-0.10， P>0.05) in themaintenance hemodialysis group, had positive significant correlation withserumADMA（r=0.50，P<0.05）.5The correlation analysis on serum NO and serum creatinine, serum ureanitrogen of uremic patients: serum NO had a significant positive correlationwith CREA(r=0.82， P<0.01), UREA (r=0.89， P<0.01) in theuremia(Non-dialysis) group.Conclusion:1The serum Hcy and serum ADMA levels of uremic groups were higherthan that of the control group, which is the important risk factor ofcardiovascular disease complications.2Hemodialysis can partially eliminated serum Hcy and serum ADMA, toimprove the endothelial function, which is beneficial to the prevention andtreatment of CVD complications of the CKD patients.3Serum Hcy had positive significant correlation with serum ADMA inESRD patients.4The serum NO levels of uremic groups were higher than that of the control group, which may be associated with the endothelium dysfunction,inflammatory factors.