Role of Asymmetric Dimethylarginine and Nitric Oxide in Type 2 Diabetes Mellitus and Its Cardiovascular Complications

Abstract

AN ENDOGENOUS inhibitor of nitric oxide synthase, asymmetric dimethylarginine (ADMA), is elevated in patients with type 2 diabetes mellitus (T2DM) and has been related to atherosclerotic disease. The study aims at investigating the status of ADMA and nitric oxide (NO) and their possible correlation inpatients with T2DM with and without cardiovascular complicationsin comparison to normalcontrols. Forty patients with T2DM and 20 age, sex and body mass index (BMI)‑matched healthy controls were included in the study. The studied individuals were divided into Group1: healthy controls (n= 20), Group 2: T2DM patients without cardiovascular complications (n= 20) and Group 3: T2DM patients with evidence of cardiovascular complications (n= 20). Serum ADMA levels were determined by enzyme linked Immunosorbent Assay (ELISA). Serum nitric oxide was measured as stable end product, nitrite. Insulin was measured by immunoradiometric method. Serum ADMA levels showed a significant elevation while serum NO levels were significantly reducedin diabetic patients groups in comparison to controls. Diabetic patients with vascular complications showed highly significant increase in ADMA levels and pronounced decrease in NO compared to those without complications. In the group of vascular complications, the ADMA level was positively correlated with postprandial serum glucose and HbA1c, but there was a negative correlation between ADMA levels and NO. ADMA and NO may serve as predictors for future cardiovascular events in T2DM patients. Further studies are required to establish the utility of decreasing ADMA levels or increasing NO in the management of T2DM patients.