A Correlation Study Of Homocysteine And Asymmetric Dimethylarginine: Relationship With Blood Pressure Among Maintained Hemodialysis Patients

A correlation study of Homocysteine and Asymmetric dimethylarginine: relationship with blood pressure among maintained hemodialysis patientsBackground and aim: homocysteine (Hcy) and asymmetric dimethylarginine (ADMA) are small molecular which can inhibit endogenous NO synthase , thus influence the function of endothelial cells of vascular.There is accumulating epidemic evidence that homocysteine is a new independent risk factor for cardiovascular disease (CVD). Meanwhile , many studies have suggested that ADMA has a strong correlation with the degree of atherosclerotic vascular disease among chronic renal disease patients. Therefore, it is postulated that homocysteine and ADMA may be involved in the progression of cardiovascular disease, such as fluctuating blood pressure, by inhibition of endogenous NO synthesis. This study is to investigate the effect of homocysteine and ADMA on endothelial cell function with measurement of blood pressure and analyzing plasma Hcy and ADMA. Method: Patients were divided into two groups: hypertension group and hypotension group (episode hypotension) . Each group includes 21 patients and blood samples were collected before hemodialysis ,in the midcourse of hemodialysis and after hemodialysis. The control group consisted 14 healthy volunteers. Samples were analzied with a high-performance liquid chromatography method,and statistic analysis was performed by SBPss 11.0.Result: Mean plasma level of homocysteine from hypertension group and hypotension group are significantly higher than control group ( 53.539 ± 21.513/nnol/l, 56.133±19.442,umol/l, 15.510±4.466μmol/l , P<0. 05), but there is no significant difference between the two patient groups. A correlation is foundbetween homocysteine plasma level and dialysis time (P<0. 05) , but there is no correlation between homocysteine plasma level and blood pressure. Mean plasma level of ADMA from hypertension group and hypotension group are significantly higher than control group (0.11074±0.031734umol/l, 0.05740±0.022475^mol/1 , 0.04314 ± 0.018303^01/1 , P<0.05 ) , and plasma level of ADMA from hypertension group is higher than hypotension group. There is a correlation between plasma level of ADMA and dialysis time (P<0. 05) , and a significant correlation is also found between plasma level of ADMA and systolic blood pressure both in hypertension group and hypotension group (P<0. 05) .Conclusion: Hyperhomocystinemia is very common in maintained hemodialysis patients, and plasma level of ADMA is also high than control group, which suggest maintained hemodialysis patients may have severe endothelial dysfunction. Thus plasma level of homocysteine and ADMA can be independent risk factor for subsequent cardiovascular disease in maintained hemodialysis patients.