The relationship between adma and endothelial dysfunction in rheumatoid patients

Rheumatoid arthritis is a chronic, inflammatory disease of the joints with multisystemic involvement. Endothelial dysfunction caused by inflammatory process increases the risk of cardiovascular disease (CVD). As a consequence the morbidity and mortality in these patients is increasing. In this study we assessed the availability of ADMA as a marker showing endotheliel dysfunction in RA patients.FMD is a radiological method that demonstrate endotheliel dysfunction. Practice difficulty and dependance on operator?s experience are disadvantages for this method. At earlier studies ADMA correlated with FMD, in showing endothelial dysfunction, can be used as a simple and a cheaper method.We have studied 40 patients below age of 65, which were diagnosed as RA by 1987 ARA classification criteria and have taken 29 , age matched and healthy, non-smoking controls. Exclusion criterias were the diagnosis of coronary and peripheral artery disease, hypertension, diabetes mellitus, smoking and renal failure. FMD and ADMA levels were measured. We have studied which factors might influenced these measurements. In this study we have determined the relationship between influenced factors and FMD, ADMA serum levels. In this study we assesed the affect of disease activity on vascular functions. Evaluation questionnaire DAS 28, CRP and ESR were done with. RA about the severity of the disease carries prognostic value of anti-CCP and RF were measured. They were looking at the relationship between endothelial dysfunction.In our study, ADMA levels were significantly higher in RA patients. ADMA level was inversely correlated with FMD. Disease duration and age of the patients affected ADMA levels. Relationship between impairment in vascular function and disease activity parameters was not detected. Significant association with anti-CCP positivity was not seen either.The results obtained in our study, supports the hypothesis that ADMA can be used in the assessment of endothelial dysfunction in patients with RA.