Relationship between asymmetric dimetil arginin and autonomic dysfunction in diabetic patients

Objective: Diabetes Mellitus is a highly prevelant disease in community. Endothelialdysfunction and autonomic dysfunction are crucial reasons that underlie themorbidity and mortality of disease. Our aim in present study was to look for if anyrelationship exist between asymmetric dimethyl arginine which is widely accepted asa marker of endothelial dysfunction and heart rate variability and heart rateturbulence parameters which are accepted as marker of autonomic dysfunction.Method: Diabetic patients and non-diabetic individuals admitted to Departments ofCardiology and Endocrinology were included in the study. Totally 142 individualswere admitted to study. 67 of these formed the group of diabetic patients followed upwith oral antidiabetics, 33 patients formed the group of diabetic patients thatfollowed up with insülin, and 42 individuals formed the control group. Bloodsamples were taken to evaluate serum asymmetric dimethyl arginine, hemogram,kidney and liver functions and lipid profile at least after eight hours of fasting. Toevaluate autonomic functions 24 hour Holter electrocardiographic monitorizationwas performed. Heart rate variability and heart rate turbulence were calculated.Results: In both of diabetic groups, heart rate variability parameters were reducedwhen compared to control group (p<0.05). When heart rate turbulence parameterswere evaluated, turbulence onset was not differing between groups (-0.0095, -0.0107,-0.0135, p=0.8). Although turbulence slope was reduced in diabetic groups comparedto control group, it did not reached to statistical significance (6.1±4, 4.6±3, 7.3±5,0.057). Serum asymmetric dimetil arginin levels were higher in diabetic groupscompared to control group (0.706, 0,708, 0,645, p=0.007). Asymmetric dimetilarginin levels were not differing between diabetic goups. When correlation analysiswas performed, no statistically significant relationship was found between serumasymmetric dimetil arginin levels with heart rate variability and heart rate turbulenceparameters.Conclusion: Serum asymmetric dimetil arginin levels are increased in diabeticpatients compared to non diabetic individuals. Heart rate variability and heart rateturbulence parameters are decreased in diabetic patients when they are comparedwith non diabetic individuals. Significant relationship between serum asymmetricdimetil arginine levels with heart rate variability and heart rate turbulence parameterscouldn?t be found.