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Elevated concentrations of asymmetric dimethylarginine are associated with deterioration of glucose tolerance in women with previous gestational diabetes mellitus
Author(s) -
Mittermayer F.,
KautzkyWiller A.,
Winzer C.,
Krzyzanowska K.,
Prikoszovich T.,
Demehri S.,
Wagner O.,
Wolzt M.
Publication year - 2007
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2007.01772.x
Subject(s) - medicine , asymmetric dimethylarginine , gestational diabetes , endocrinology , impaired glucose tolerance , interquartile range , diabetes mellitus , insulin resistance , glucose tolerance test , pregnancy , gestation , arginine , chemistry , biology , biochemistry , amino acid , genetics
. Objective. Women with previous gestational diabetes mellitus (GDM) have a high risk for development of type 2 diabetes mellitus. The endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) could be related to disorders of the glucose metabolism. To evaluate if ADMA predicts deterioration of glucose tolerance in women with previous GDM and to assess concentration changes we analysed ADMA in women with previous GDM after delivery and after a median follow‐up of 2.75 years (interquartile range: 1.47–4.60). Design. Prospective cohort study. Subjects and methods. ADMA, symmetric dimethylarginine (SDMA) and l ‐arginine were determined in 77 women with previous GDM who underwent a 75‐g oral glucose tolerance test 4 months after delivery and at follow‐up. Results. Deterioration in glucose tolerance was observed in 36% of the women with ADMA above and 11% of those with ADMA below the median (0.56 μ mol L −1 ; P = 0.008, log‐rank test). ADMA correlated significantly with mean arterial blood pressure and nonsignificantly with body mass index ( P = 0.050) but not with insulin resistance, fasting glucose, lipids or glomerular filtration rate. The fully adjusted hazard ratio for a decline of glucose tolerance during follow‐up was 3.94 (95% CI: 1.16–13.37; P = 0.028) for subjects with ADMA above the median. SDMA and l ‐arginine were not associated with changes in the glucose tolerance status. ADMA and l ‐arginine decreased significantly during follow‐up. Conclusions. High serum ADMA after delivery is associated with deterioration in glucose tolerance in women with previous GDM and declines in the following years.