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The plasma levels of homoarginine (h-Arg) and methylated arginine have proven to be an independent cardiovascular risk factor. We aimed to determine the h-Arg and methyl arginine levels in serums of high-risk pregnancy causing potential complications. These participants were divided into four groups as the control group with quadruple test, the high-risk group quadruple test the control group with binary test, the high-risk group with quadruple test that have a positive result from second-trimester screening with a cut-off value of 1 in 300. The serum methyl arginine and homoarginine levels were analysed with liquid chromatography-tandem mass spectrometry. Serum h-Arg levels were found to be higher in high-risk groups compared to control groups and it was also detected higher in the groups with quadruple test than the groups with binary test ( p  &lt; .05). H-Arg levels in the groups showed strong negative correlation with age and serum inhibin-A levels ( r  = −0.288,  p  &lt; .001). Also, there was a strong negative correlation between serum asymmetric dimethylarginine (ADMA) and serum inhibin-A levels ( r  = −0.352,  p  &lt; .001). H-Arg may be a new risk marker to detect high-risk pregnancies in early pregnancy. In addition to, methylated arginine such as ADMA has a key regulator in a physiological concentration of h-Arg.IMPACT STATEMENTWhat is already known on this subject?  H-Arg levels decrease may be associated with preeclampsia, GDM, macrosomia, low birth weight, and preterm delivery in pregnancy.What do the results of this study add?  Serum h-Arg levels were found to be higher in high-risk groups. Additionally, h-Arg levels and ADAM, one of the methylated arginines in the groups showed a strong negative correlation with serum inhibin-A levelsWhat are the implications of these findings for clinical practice and/or further research?  H-Arg may be a new risk marker to detect high-risk pregnancies What is already known on this subject?  H-Arg levels decrease may be associated with preeclampsia, GDM, macrosomia, low birth weight, and preterm delivery in pregnancy. What do the results of this study add?  Serum h-Arg levels were found to be higher in high-risk groups. Additionally, h-Arg levels and ADAM, one of the methylated arginines in the groups showed a strong negative correlation with serum inhibin-A levels What are the implications of these findings for clinical practice and/or further research?  H-Arg may be a new risk marker to detect high-risk pregnancies

Quantification of serum homoarginine, methylated arginine and inhibin-A levels in a high-risk pregnancy