Low Levels of Asymmetric Dimethylarginine in Children with Diabetes Mellitus Type I Compared with Healthy Children

Huemer, Martina; Simma, Burkhard; Mayr, Dieter; Mühl, Adolf; Rami, Birgit; Schober, Edith; Ulmer, Hanno; Zanier, Ulrike; Bodamer, Olaf A.

doi:10.1016/j.jpeds.2010.09.058

« Previous Next »The Journal of Pediatrics
Volume 158, Issue 4 , Pages 602-606.e1, April 2011

Low Levels of Asymmetric Dimethylarginine in Children with Diabetes Mellitus Type I Compared with Healthy Children

Martina Huemer, MD
- Department of Pediatrics, Landeskrankenhaus Bregenz, Bregenz, Austria and University Children's Hospital Zürich, Zürich, Switzerland
- Reprint requests: Martina Huemer, MD, Department of Pediatrics, Landeskrankenhaus Bregenz, Carl Pedenz Str 2, 6900 Bregenz, Austria.
Burkhard Simma, MD
- Department of Pediatrics, Landeskrankenhaus Feldkirch, Feldkirch, Austria
Dieter Mayr, MD
- Department of Pediatrics, Landeskrankenhaus Bregenz, Bregenz, Austria and University Children's Hospital Zürich, Zürich, Switzerland
Adolf Mühl, PhD
- Centogene Vienna, Vienna, Austria
Birgit Rami, MD
- University Children’s Hospital Vienna, Vienna, Austria
Edith Schober, MD
- University Children’s Hospital Vienna, Vienna, Austria
Hanno Ulmer, PhD
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
Ulrike Zanier, MD
- Department of Pediatrics, Krankenhaus Dornbirn, Dornbirn, Austria
Olaf A. Bodamer, MD
- University Children’s Hospital and Institute for Inborn Errors of Metabolism, Paracelsus Medical University, Salzburg, Austria

Received 17 March 2010; received in revised form 30 August 2010; accepted 17 September 2010. published online 15 November 2010.

Objective

Although high levels of asymmetric dimethylarginine (ADMA) are associated with an increased risk for vasculopathy in adults, elevated ADMA concentrations also have been found in healthy young children. Patients with diabetes mellitus type 1 (DM1) are at risk for vasculopathy, and because the function of ADMA in the development of vascular symptoms is incompletely understood, we investigated ADMA concentrations in pediatric patients with DM1 compared with healthy age- and sex-matched individuals.

Study design

This cross-sectional study included 85 pediatric patients with DM1 and 89 age- and sex-matched healthy controls.

Results

ADMA concentrations were significantly lower in the patients with DM1 and were inversely correlated with hemoglobin A1c concentrations.

Conclusions

Besides its vasoprotective function, nitric oxide itself may exert oxidative stress by generating free radicals. In these circumstances, ADMA would protect the system from nitric oxide overproduction and perpetuation of oxidative stress. This theory is supported by the physiologically higher ADMA concentrations in healthy children. Thus, low ADMA concentrations in children with DM1 may be an indicator of impaired protection against oxidative stress.

ADMA, Asymmetric dimethylarginine, BP, Blood pressure, BMI, Body mass index, DDAH, Dimethylarginine dimethylaminohydrolase, DM1, Diabetes mellitus type 1, HDL, High-density lipoprotein, HbA1c, Hemoglobin A1c, NO, Nitric oxide, NOS, Nitric oxide synthase, tHcy, Total homocysteine