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Asymmetric dimethylarginine is not elevated in exfoliation syndrome but symmetric dimethylarginine is related to exfoliative glaucoma

  • Clinical Investigation
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Abstract

Background

Hyperhomocysteinemia (HH), oxidative stress and endothelial dysfunction are all implicated as possible pathogenetic factors in exfoliation syndrome (XFS) and exfoliative glaucoma (XFG). Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial nitric oxide and plasma level of ADMA is often elevated in HH. Thus the present study was undertaken to study plasma levels of ADMA with concomitant measurement of symmetric dimethylarginine (SDMA) and L-arginine (L-Arg) in XFS and XFG.

Methods

This cross-sectional, prospective study involved 36 XFS patients, 11 of them having XFG, and 36 age- and gender-matched controls. Fasting plasma ADMA, SDMA and L-Arg levels of participants were determined. A special view was created how plasma L-Arg, ADMA and SDMA correlate to plasma homocysteine (P-Hcy). In addition, the influence of P-Hcy values derived from our previous study on the above mentioned parameters were evaluated by cut-off values of P-Hcy, 12 μmol/l for women and 14.5 μmol/l for men.

Results

The mean plasma ADMA, SDMA and L-Arg levels were 0.41, 0.49 and 62.9 μmol/l in the XFS/XFG group, and 0.41, 0.44 and 69.7 μmol/l in the control group, respectively. As all parameters within the XFS and control group were compared, no statistical significance was stated. On the other hand, a positive correlation was observed between plasma SDMA and P-Hcy in XFGs (P=0.002), and additionally, also a statistically significant difference was in plasma SDMA between the two groups sorted by cut-off levels of P-Hcy 0.49±0.15 vs 0.36±0.04 μmol/l, above and below cut-off levels, respectively (P=0.001), but not between ADMA in a respective assay. The mean values of L-Arg were 64.6±17.2 vs 74.8±13.3 μg/l, respectively (P=0.031). In the XFS subgroup, on the contrary, there was no positive correlation between P-Hcy and plasma SDMA.

Conclusions

A positive correlation of plasma SDMA in respect to P-Hcy in XFGs and increase of SDMA in mild or intermediate hyperhomocysteinemia may indicate SDMA as a marker of developing XFG in hyperhomocysteinemic subjects.

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Acknowledgement

The authors thank Ms L. Karjalainen, MSc, for performing statistical analyses.

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Authors and Affiliations

  1. Eye Policlinic, Institution of Deacony, Sibeliuksenkatu 6 C, 15110, Lahti, Finland

    Hillevi Blomster

  2. Department of Ophthalmology, Kuopio University Hospital and Kuopio University, Kuopio, Finland

    Tuomo Puustjärvi, Markku Teräsvirta & Hannu Uusitalo

  3. Department of Ophthalmology, North Karelia Central Hospital, Joensuu, Finland

    Matti Kontkanen

  4. Laboratory Centre, Kuopio University Hospital, Kuopio, Finland

    Pirjo Valtonen

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  1. Hillevi Blomster
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Correspondence to Hillevi Blomster.

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Blomster, H., Puustjärvi, T., Kontkanen, M. et al. Asymmetric dimethylarginine is not elevated in exfoliation syndrome but symmetric dimethylarginine is related to exfoliative glaucoma. Graefe's Arch Clin Exp Ophthalmol 245, 204–209 (2007). https://doi.org/10.1007/s00417-006-0425-0

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  • DOI: https://doi.org/10.1007/s00417-006-0425-0

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