Symmetric dimethylarginine (SDMA) indirectly inhibits nitric oxide (NO) synthesis and predicts cardiovascular and all-cause
mortality in high-risk patients. The aim of our study was to investigate the associations of cumulative inflammatory burden
(assessed by serial measurements of inflammatory markers) and classical cardiovascular (CV) disease risk factors with SDMA
in RA patients. 201 RA patients (155 females, median age 67 (59–73)) were assessed at baseline (2006). Classical CV disease risk
factors were recorded and systemic inflammation was determined by themeasurement of C-reactive protein (CRP) and erythrocyte
sedimentation rate (ESR). At follow-up (2012) SDMA levels were measured by enzyme-linked immunosorbent assay.Mean SDMA
levels in RA population were 0.40 (0.40–0.53) ����mol/L. No significant association between SDMA and cumulative inflammatory
load was established in the analysis. SDMA levels were not found to be significantly related to CV disease risk factors.We explored
the potential relationship between SDMA and cumulative inflammatory burden in patients with RA and obtained negative results.
SDMA did not relate to CV disease risk factors in our population and its clinical significance as a surrogate marker of endothelial dysfunction in patients with RA remains to be determined.