Key result
Type 2 diabetes and prediabetes linked to ~2-fold higher ADMA levels, suggesting early endothelial damage.
Why the study?
It remained unclear whether asymmetric dimethylarginine is merely a marker of cardiovascular episodes or an independent risk factor.
Are ADMA concentrations and angiogenic potential altered in patients with prediabetes and type 2 diabetes compared to healthy subjects?
Cross-Sectional (n=95)
No
Are ADMA concentrations and angiogenic potential altered in patients with prediabetes and type 2 diabetes compared to healthy subjects?
Absolute Event Rate: 19.4% vs 9.2%
p-value: p=<0.006
Elevated ADMA and altered angiogenic potential are present even in prediabetes, suggesting early endothelial damage before overt type 2 diabetes diagnosis.
ADMA elevation may flag early endothelial risk in prediabetes; hypothesis-generating and leaves open predictive value for outcomes in prospective studies.
Asymmetric dimethylarginine is an endogenous competitive inhibitor of nitric oxide synthase and marker of endothelial dysfunction, but the question remains as to whether asymmetric dimethylarginine is a marker of cardiovascular episodes or their independent risk factor. ADMA/DDAH (dimethylaminohydrolase) pathway regulates vascular endothelial growth factor (VEGF)-mediated angiogenesis due to its impact on the NO formation. The aim of the study was to assess the concentrations of asymmetric dimethylarginine and the angiogenic potential in the blood of subjects with type 2 diabetes (T2DM, n = 33) and patients with prediabetes ( n = 32)—impaired fasting glycemia and/or impaired glucose tolerance (WHO criteria). The study found that both the prediabetes group and subjects with T2DM had significantly elevated concentrations of asymmetric dimethylarginine, significantly high levels of VEGF-A, low ratio of sVEGF-R1/VEGF-A, and sVEGF-R2/VEGF-A. This may suggest endothelial damage at early stages of carbohydrate metabolism dysfunction—before T2DM is diagnosed. Higher proangiogenic potential in prediabetes and T2DM patients than in healthy subjects, is not only the effect of an increase in VEGF-A levels, but also reduced inhibition of circulating receptors.
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Wieczór et al. (2020) conducted a cross-sectional in Type 2 diabetes and prediabetes (n=95). Type 2 diabetes and prediabetes vs. Healthy subjects without carbohydrate metabolism dysfunction was evaluated on ADMA concentration (ng/mL) (p=<0.006). Patients with type 2 diabetes and prediabetes had significantly elevated concentrations of ADMA (19.4 and 18.7 ng/mL, respectively) compared to healthy controls (9.2 ng/mL), suggesting early endothelial damage.
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