Severe preeclampsia was associated with significantly elevated third-trimester plasma ADMA concentrations compared to normotensive pregnancies (0.55 vs 0.36 micromol/l; p<0.05).
Case-Control (n=24)
Are circulating concentrations of ADMA and arginine altered in women with severe preeclampsia compared to normotensive pregnant women?
Elevated circulating ADMA concentrations and a lower arginine/ADMA ratio in the third trimester suggest that endogenous nitric oxide synthesis inhibitors may play a pathophysiological role in severe preeclampsia.
Absolute Event Rate: 0.55% vs 0.36%
p-value: p=<0.05
OBJECTIVES: To study endogenous nitric oxide (NO) synthesis inhibitors in preeclampsia by measuring asymmetric dimethyl arginine (ADMA) and arginine. STUDY DESIGN: Blood samples for measurement of plasma concentrations of ADMA and arginine were obtained antepartum (range 32-39 weeks gestation), 3-5 days postpartum and 3 months postpartum from 12 pregnant women with severe preeclampsia and from a normotensive pregnant control group (n=12). RESULTS: During the third trimester, plasma ADMA was elevated (p<0.05) in the preeclampsia patients (0.55+/-0.02 micromol/l) compared to the normotensive pregnant controls (0.36+/-0.01 micromol/l). Since plasma arginine levels did not differ between preeclamptic and normotensive control women (80.7+/-5.8 micromol/l) and 74.5+/-3.8 micromol/l respectively), the plasma arginine/ADMA ratio was lower (p<0.05) in the preeclamptic group (145.6+/-10.5) compared to the normotensive controls (211.0+/-14.3). Three days post partum there was an increase (p<0.05) in plasma ADMA in both the preeclamptic (0.67+/-0.03 micromol/l) and the normotensive control group (0.64+/-0.03 micromol/l). This was accompanied by a rise (p<0.05) in plasma arginine levels in both the preeclamptic patients (112.9+/-10.5 micromol/l) and the normotensive control group (121.7+/-9.6 micromol/l). At this time point there was no difference in plasma arginine/ADMA ratio between the groups. Three months postpartum, plasma ADMA levels were slightly lower in both groups compared to the postpartum values (preeclampsia: 0.56+/-0.03 micromol/l, normotensive pregnant control: 0.52+/-0.03 micromol/l). CONCLUSION: Elevated circulating ADMA concentrations in combination with low plasma arginine levels may be of pathophysiological importance in pregnancies complicated with preeclampsia.
Pettersson et al. (Sat,) conducted a case-control in Severe preeclampsia (n=24). Severe preeclampsia vs. Normotensive pregnancy was evaluated on Plasma ADMA concentration during the third trimester (micromol/l) (p=<0.05). Severe preeclampsia was associated with significantly elevated third-trimester plasma ADMA concentrations compared to normotensive pregnancies (0.55 vs 0.36 micromol/l; p<0.05).