Increased Serum Levels of Asymmetric Dimethylarginine and Symmetric Dimethylarginine and Decreased Levels of Arginine in Sudanese Patients with Essential Hypertension

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Abstract

Introduction: Essential hypertension (EH) is a disease caused by various environmental and genetic factors. Nitric oxide (NO) is important for the functional integrity of the endothelium. It is produced in endothelial cells by endothelial NO synthase (eNOS) that mediates the conversion of the amino acid arginine into NO and citrulline. Asymmetric dimethylarginine (ADMA) acts as an inhibitor of eNOS. In contrast, symmetric dimethylarginine (SDMA) has no direct effect on eNOS but plays an important role competing with arginine for transport across the amino acid transporter. ADMA and SDMA have been found to play a central role in the development of cardiovascular diseases. Serum ADMA levels may serve as a future diagnostic marker and a target of therapy in hypertensive patients in the Sudanese population. This study aimed to investigate the relation between serum arginine, ADMA, and SDMA levels with EH in the Sudanese population. Methods: Patients ( n = 260) with established hypertension and controls ( n = 144) with normal blood pressure were included in this case-control study. Serum blood samples were analyzed for arginine, ADMA, and SDMA, using high-performance liquid chromatography-tandem mass spectrometry. Other laboratory data were measured using routine methods. Mann-Whitney’s U test and χ<sup>2</sup> tests were used for continuous and categorical data, respectively. A multivariate logistic regression analysis was conducted to investigate the independent effect of multiple variables on the development of hypertension. Results: Serum arginine levels were significantly lower in the patient group than in the control group ( p < 0.001). ADMA and SDMA levels were significantly higher in the patient group than the control group ( p < 0.001, p = 0.001, respectively). Multivariate logistic regression analysis showed that only older age, being a male, and arginine levels are independent factors controlling the development of hypertension ( p < 0.001, p < 0.001, and p = 0.046, respectively). ADMA and SDMA levels were not independent factors for the development of hypertension. Conclusions: This study demonstrated increased serum levels of ADMA and SDMA and decreased arginine levels in Sudanese patients with EH. Lowering serum ADMA levels or increasing the arginine levels might be a novel therapeutic target in these individuals.

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Author and article information

Journal

Journal ID (publisher-id): KBR

Journal ID (nlm-ta): Kidney Blood Press Res

Journal ID (doi): 10.1159/issn.1420-4096

Title: Kidney and Blood Pressure Research

Publisher: S. Karger AG

ISSN (Print): 1420-4096

ISSN (Electronic): 1423-0143

Publication date Subscription-year: 2020

Publication date (Print): October 2020

Publication date (Electronic): 19 August 2020

Volume: 45

Issue: 5

Pages: 727-736

Affiliations

[_a] _aDepartment of Biochemistry, Faculty of Medicine, University of Khartoum, Khartoum, Sudan

[_b] _bInstitute for Cardiogenetics, University of Lübeck, Lübeck, Germany

[_c] _cDZHK (German Research Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Hamburg/Kiel/Lübeck, Germany

[_d] _dUniversity Heart Center Lübeck, Lübeck, Germany

[_e] _eDepartment of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

[_f] _fDepartment of Clinical Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia

[_g] _gDepartment of Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan

Author notes

*Sahar Gamil, Department of Biochemistry, University of Khartoum, Al-Qasr Street, Khartoum (Sudan), dr_sahar_sj@hotmail.com

Author information

Sahar Gamil https://orcid.org/0000-0003-3994-4845

Article

Publisher ID: 508695 Other ID: Kidney Blood Press Res 2020;45:727–736

DOI: 10.1159/000508695

PubMed ID: 32814314

SO-VID: ef327bbd-5cf7-45ff-a5d0-d20e5550f2ac

License:

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History

Date received : 13 June 2019

Date accepted : 14 May 2020

Page count

Figures: 1, Tables: 5, Pages: 10

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