A Study Of Asymmetric Dimethylarginine And Homocysteine: Relationship With Cerebral Infarction

Study backgroud and Objective:Asymmetric dimethylarginine(ADMA)and Homocysteine(Hcy)are kinds of small molecule amino acid substances of impact on vascular activity,both of which influence on the function of vascular endothelial cells by inhibition of nitric oxide (NO)synthesis.Large number of epidemiological data show that serum Hcy levels is a new independent risk factor of cardio-cerebral vascular diseases;meanwhile many studies show that,ADMA levels are obviously correlation with vascular endothelial dysfunction and atherosclerosis relevant,and that atherosclerosis is the pathological basis of cardio-cerebral vascular diseases.So,ADMA and Hcy may be speculated to impact on the function of vascular endothelial cells affected by the level of NO,which involve in the cardiovascular and cerebrovascular diseases of the mechanism.This study observed the relationship among ADMA,Hcy and cerebral infarction,and the relevance between ADMA and Hcy through determining the level of ADMA,Hcy of cerebral infarction patients;And explored the pathogenesis which ADMA and Hcy lead to atherosclerosis and cerebral infarction.It will provide the basis for early detection,diagnosis of cerebral infarction,and theoretical guidance and objective basis for early intervention and clinical drugs for treatment of cerebral infarction.Materials and Methods:A case-control study is adopted to select patients with acute cerebral infarction in 73 cases,45 cases of healthy controls,all subjects are examined in the incidence of acute cerebral infarction within one week,and collected venous blood after fasting time more than12 hours,blood are analyzed by the high performance liquid chromatography after centrifuging.Numerical values are given as mean±standard deviation,Allst atistical analyses were performed with SPSS 15.0.t-test if variance equal otherwiseusi ng t' Testing was used to analyse two independent samples;variance-analysis and q test were used to analyse several independent samples.The correlations among ADMA and Hcy and other risk factors were analysed by linear correlation.Relevant between ADMA and Hcy were analysed by partial correlation analysis.Logistic regression analysis was used to analyse which was the independent risk factor for cerebral infarction.Results:1.Serium ADMA levels CI group(0.70±0.26μmol/L)was significantly higher than that of control group(0.45±0.10μmol/L)(P＜0.01),and ADMA was positively correlated with age,hypertension(P＜0.01),There were not relevance among TC,TG smoking,drinking.2.Serum Hcy levels of acute cerebral infarction group(35.37±16.17μmol/L) was significantly higher than that of control group(17.40±5.17μmol/L)(P＜0.01), and Hcy was positively correlated with age,hypertension(P＜0.01),There were not relevance among TC,TG smoking,drinking.3.Subgroup analysis,the recurrence of cerebral infarction group ADMA(0.80±0.28μmol/L)significantly higher than the first group of cerebral infarction ADMA(0.62±0.21μmol/L)(P＜0.01)there were significant differences;recurrence Cerebral infarction group Hcy(40.47±17.98μmol/L)significantly higher than the first group of cerebral infarction Hcy(31.16±13.31μmol/L)(P＜0.05)differences are statistically significant.4.In sub-group analysis,cerebral infarction with hypertension ADMA(0.85±0.23μmol/L)significantly higher than that of cerebral infarction group ADMA(0.53±0.19μmol/L)(P＜0.05),hypertension control group ADMA(0.50±0.09μmol/L) higher than the control group without hypertension ADMA(0.39±0.09μmol/L)(P＜0.05),purely cerebral infarction group ADMA levels and hypertension control group,no statistically significant difference(P＞0.05).5.In sub-group analysis,cerebral infarction with hypertension Hcy(42.34±17.03μmol/L)significantly higher than that of cerebral infarction group Hcy(27.37±10.64μmol/L)(P＜0.05),and only a high level of CI group Hcy hypertension in the control group Hcy(18.61±4.56μmol/L)(P＜0.05),hypertension control group Hcy levels and hypertension control group without Hcy(16.12±5.55μmol/L),an increasing level,but the difference was not significant(P＞0.05).6.In the control of hypertension,age,TG,and other risk factors,the partial correlation analysis showed that ADMA was positively correlated with Hcy.7.Logistic regression analysis showed that,ADMA,Hcy were respectively potential risk factor for cerebral infarction.Conclusions:1.ADMA,Hcy level of acute cerebral infarction patients were higher than that of control group.So ADMA,Hcy were potential risk factors of cerebral infarction.2.ADMA,Hcy level of cerebral infarction with hypertension were higher than that of simple cerebral infarction group,ADMA,Hcy were predictors for the development to cerebral infarction in hypertension patients.3.Recurrent stroke in the group ADMA,Hcy level higher than the first group of cerebral infarction,ADMA,Hcy and the development of cerebral infarction had close-up relationships,increased level of ADMA,Hcy were important factors of recurrent stroke.4.Controlling for other factors,the partial correlation analysis suggested that ADMA was positively correlated with Hcy and presumed that Hcy may affect vascular endothelial function through ADMA,leading to atherosclerosis and then cerebralin farction.