Electronic versions

  • T Dimitroulas
    Department of Rheumatology, Russells Hall Hospital, Dudley Group of Hospitals, Dudley DY1 2HQ, West Midlands, UK. dimitroul@hotmail.com
  • A Sandoo
    Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, UK.
  • J J J C S Veldhuijzen van Zanten
  • J P Smith
  • J Hodson
  • G S Metsios
  • A Stavropoulos-Kalinoglou
  • G D Kitas

OBJECTIVE: To determine whether demographic, inflammatory, and metabolic factors predict elevated asymmetric dimethylarginine (ADMA) levels in rheumatoid arthritis (RA).

METHOD: A total of 67 RA patients [mean age 56 ± 12 years, median disease duration 8 (3-15) years] were assessed. Routine biochemistry tests, lipid profile, glycaemic profile [glucose, insulin, homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI)], and inflammatory markers were measured in all patients. ADMA levels were measured by enzyme-linked immunosorbent assay (ELISA). Regression analyses were performed to identify predictors of ADMA in RA.

RESULTS: Regression analysis revealed that HOMA (β = 0.149, p = 0.003) was an independent predictor of ADMA in RA. From the drug factors, anti-hypertensive medication use was associated with lower ADMA levels (β = -0.081, p = 0.004). ADMA was not associated with RA disease-related parameters or any of the other cardiovascular risk factors that were assessed.

CONCLUSIONS: HOMA, a strong indicator of insulin resistance, seems to be the main predictor of elevated ADMA levels in RA patients; ADMA may reflect an important pathway linking abnormal insulin metabolism with endothelial dysfunction in RA.


  • Adult, Aged, Arginine, Arthritis, Rheumatoid, Female, Homeostasis, Humans, Insulin Resistance, Male, Middle Aged, Journal Article, Research Support, Non-U.S. Gov't
Original languageEnglish
Pages (from-to)176-81
Number of pages6
JournalScandinavian Journal of Rheumatology
Issue number3
Publication statusPublished - 2013
Externally publishedYes
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