SERUM ASYMMETRIC DIMETHYL ARGININE (ADMA) AND ARGININE LEVELS AS PREDICTORS OF VASCULAR COMPLICATIONS IN TYPE 2 DM
Karthik G.* and Ravi Kumar Y. S.
Insulin resistance in DM is associated with reduced nitric oxide (NO) bioavailability and endothelial dysfunction. Endothelial dysfunction due to reduced nitric oxide (NO) bioavailability is an earliest change and prominent feature of insulin resistance.[1,5,6,7] Deficiency of NO increases vascular resistance and promotes atherogenesis. L-Arginine is a common precursor for nitric oxide (NO), act as substrate for enzymes involved in nitric oxide synthases.[2,3] Asymmetric di methyl arginine (ADMA) which is a product of protein methylation on arginine is an endogenous competitive inhibitor of NO synthesis that exerts pro atherogenic effect. This study aim to correlate levels of serum Arginine and serum ADMA in DM with vascular complications and without vascular complications as compared with non diabetic subjects. This study concluded that Serum Arginine concentration is low among Diabetics as compared with Non diabetics and Arginine level was significantly low in subjects with vascular complications associated with diabetes mellitus as compared with Diabetics without vascular complications and Non diabetic subjects and also Serum arginine was inversely related to HbA1c. Serum ADMA level was high among Diabetics as compared with Non Diabetics and Serum ADMA levels were significantly high among diabetes with vascular complications as compared with diabetes without vascular complications and Non diabetic subjects and Serum ADMA levels were elevated in proportion to HbA1c. Hence it is suggestive that early supplementation of Arginine which is a precursor of NO, may retard progression of vascular complications associated with Diabetes mellitus.[8,9]
Keywords: ADMA: Asymmetric di methyl arginine, DM: Diabetes Mellitus.
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