Disfunção endotelial avaliada por dimetilarginina assimétrica e desfechos metabólicos e renais em pacientes hipertensos

• Autor(a) principal: Triches, Cristina Bergmann [UNIFESP]
• Data de Publicação: 2018
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6308191; https://repositorio.unifesp.br/handle/11600/52243
• topic: Dimetilarginina assimétrica; Fatores de risco cardiovascular; Diabetes melitus Tipo 2; Síndrome metabólica; Doença cardiovascular; Morte cardiovascular; Albuminúria; Doença renal crônica; Asymmetric dimethylarginine; Cardiovascular risk factors; Diabetes melitus type 2; Metabolic syndrome; Cardiovascular disease; Cardiovascular death; Albuminuria; Chronic kidney disease

Asymmetric dimethylarginine (ADMA), which is the main endogenous inhibitor of nitric oxide synthase, plays a critical role in the process of endothelial dysfunction. We evaluated the association between high plasma ADMA levels in hypertensive patients and the presence of cardiovascular risk factors, the development of type 2 diabetes mellitus (DM) and the development of cardiovascular outcomes, including death. We evaluated 191 hypertensive patients who were stratified into 2 groups according to the median value of basal ADMA: those with high levels of plasma ADMA (> 0.55 μmol/L) and low levels of plasma ADMA (≤ 0.55 μmol/L) who were prospectively evaluated over 5.8 years. High ADMA levels were seen in patients with higher weight, body mass index (BMI), waist circumference, triglycerides, uric acid, and high-sensitivity C-reactive protein (hs-CRP), and lower levels of HDL-col and in type 2 diabetic patients. There was an association between high plasma ADMA levels and the occurrence of cardiovascular death. In a subgroup of hypertensive patients free from metabolic syndrome (MS) and DM at baseline, there was an association between high ADMA levels and the development of type 2 DM. In conclusion, our study confirms the association of high plasma ADMA levels and the presence of cardiovascular risk factors in hypertensive patients and suggests a positive predictive value of high plasma ADMA levels for cardiovascular death in hypertensive patients and also for the development of type 2 DM in a subgroup of hypertensive patients free from metabolic abnormalities.