Abstract T P161: Asymmetric Dimethylarginine, C-reactive Protein, and the Risk of Developing Metabolic Syndrome in Middle-Aged Men

Abstract

BACKGROUND: The metabolic syndrome has known as an independent risk factor of stroke. We have recently shown that the measurement of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, may be useful for identifying individuals with a high risk of stroke among Japanese population. We aimed to examine whether serum levels of ADMA and a high-sensitivity C-reactive protein (hs-CRP) are associated with the risk of developing metabolic syndrome in middle-aged men. METHODS: In this longitudinal study, serum ADMA and hs-CRP levels were measured in Japanese men without metabolic syndrome, which was diagnosed according to the currently accepted unified criteria. The subjects were followed-up for a maximum of four years to determine new-onset metabolic syndrome. A Cox proportional hazards model with adjusting for potential confounders was applied to determine the hazard ratio (HR) for developing metabolic syndrome according to serum levels of ADMA and hs-CRP, considered either alone or in combination. RESULTS: Of the 848 subjects (mean age, 43 ± 6 years), 100 subjects developed metabolic syndrome. High ADMA levels (≥ 0.45μmol/L) alone did not show a significant HR for developing metabolic syndrome, while high hs-CRP levels (≥ 0.3 mg/L) did (HR 1.82, 95% CI 1.17-2.83). The combination of high levels of both hs-CRP and ADMA had a high HR (2.32, 95% CI 1.30-4.14) as compared to low levels of both markers. In contrast, the HR was not significant in the combination of high hs-CRP and low ADMA levels, as well as low hs-CRP and high ADMA levels. CONCLUSIONS: Serum hs-CRP, but not ADMA, levels were associated with the risk of metabolic syndrome. Furthermore, the combination of high ADMA and high CRP levels increased the risk of metabolic syndrome. Hence, further studies are needed, but measuring the new combination of two markers may potentiate the predictive value for developing cardiovascular diseases including stroke.