• apolipoproteins;
  • endothelium-dependent vasodilation;
  • low-density lipoprotein-cholesterol;
  • total homocysteine;
  • ultrasound


Background:  Little is know about the relationship between asymmetric dimethylarginine (ADMA) and percent flow-mediated dilatation (%FMD) in subjects with severe hypercholesterolemia (HH).

Aim:  The aim the present study was the evaluation of the relationship of ADMA to %FMD, as well as to lipid parameters and other markers of endothelial dysfunction in newly detected subjects with severe HH.

Methods:  One hundred and twenty asymptomatic patients with severe, newly detected HH and 100 controls were evaluated. The plasma level of ADMA was tested by ELISA and total homocysteine (tHcy) – through fluid chromatographic analysis. The %FMD was evaluated by the diameter of brachial artery with 7·5 MHz transducer of HP SONOS 5500.

Results:  Significant difference was found between patients and controls, (P<0·05) regarding lipid total cholesterol, triglycerides, high-density lipoprotein, low-dencity lipoprotein, atherogenic indices) and non-lipid markers (ADMA, sICAM-1, sVCAM-1), as well as the endothelium dependent %FMD in contrast to flow independent vasodilation. (P>0·05) No significant difference was found between the groups with respect to tHcy, P-selectine and E-selectine. (P>0·05) A strong negative correlation was found between %FMD and ADMA. (rxy = −0·895; P<0·001), Apolipoprotein-B (rxy = −0·687; P<0·0001, tHcy (rxy = −0·560; P<0·001) and Apolipoprotein index –B/A1 (rxy = −0·518; P<0·001). The subsequent linear and multiple regression analysis selected ADMA as the most significant factor in relation to %FMD.

Conclusion:  It is concluded that ADMA is the basic modulator of %FMD among all tested atherogenic risk biomarkers in in newly detected subjects with severe HH.