Exploring disease activity and cardiovascular events by raised serum asymmetric dimethyl arginine among systemic lupus erythematosus patients

Asymmetric Dimethyl Arginine (ADMA) is an endogenous nitric oxide inhibitor and a potential independent risk factor for endothelial dysfunction and cardiovascular disease. The current study attempted to investigate the association of serum ADMA levels to serological markers and cardiovascular events among Systemic Lupus Erythematosus (SLE) patients. The study included 45 subjects (91.1% female), divided equally into 3 groups: patients with lupus flare, patients without flare according to SLE Disease Activity Index (SLEDAI), and apparently healthy individuals. Serum ADMA, ANA, Anti-ds DNA, C3, ESR, and lipid profile were measured. There was a significantly higher ADMA level among active patients, with history of cardiovascular events, compared to inactive and control subjects. There were positive correlations between ADMA levels and anti-ds DNA, ESR, SLEDAI, and cardiovascular events, but negative correlation with C3, LDL, HDL and total cholesterol. In conclusion, high serum ADMA level may represents an independent risk factor for disease activity and poor prognosis among lupus patients.