Early-pregnancy asymmetric dimethylarginine (ADMA) levels in women prone to develop recurrent hypertension

C A H Rijvers; S Marzano; B Winkens; J A Bakker; A A Kroon; M E A Spaanderman; L L H Peeters

doi:10.1016/j.preghy.2013.01.001

Early-pregnancy asymmetric dimethylarginine (ADMA) levels in women prone to develop recurrent hypertension

Pregnancy Hypertens. 2013 Apr;3(2):118-23. doi: 10.1016/j.preghy.2013.01.001. Epub 2013 Jan 17.

Authors

C A H Rijvers¹, S Marzano², B Winkens³, J A Bakker⁴, A A Kroon⁵, M E A Spaanderman⁶, L L H Peeters⁷

Affiliations

¹ Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: carmen.rijvers@maastrichtuniversity.nl.
² Department of Obstetrics and Gynecology, Universita La Sapienza, 00185 Rome, Italy. Electronic address: sara1081@inwind.it.
³ Department of Methodology and Statistics, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: bjorn.winkens@maastrichtuniversity.nl.
⁴ Department of Clinical Genetics, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: jaap.bakker@mumc.nl.
⁵ Department of Internal Medicine, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: aa.kroon@mumc.nl.
⁶ Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: marc.spaanderman@mumc.nl.
⁷ Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: l.l.h.peeters@umcutrecht.nl.

PMID: 26105948
DOI: 10.1016/j.preghy.2013.01.001

Abstract

Objective: To evaluate early-pregnancy levels of ADMA (asymmetric dimethylarginine) in recurrent hypertensive pregnancy.

Study design: In this retrospective observational study, blood samples from 35 normotensive women with a previous hypertensive pregnancy were obtained preconceptionally and at 12, 16 and 20weeks in their next pregnancy. We assessed ADMA, symmetric dimethylarginine (SDMA), l-arginine and l-citrulline. We analyzed differences in longitudinal patterns between normotensive (NT, n=18) and recurrent hypertensive (HT, n=17) pregnancies by linear mixed models, with a sub-analysis for preeclampsia (PE, n=6).

Main outcome measures: ADMA, SDMA, l-arginine and l-citrulline.

Results: Pre-pregnant SDMA and l-citrulline were lower in HT. At 12weeks, ADMA and ADMA/SDMA ratio correlated inversely with PAPP-A and β-hCG, respectively. In both groups, ADMA-related compounds changed inconsistently with advancing (mid-trimester) pregnancy, although in HT, l-arginine tended to decrease between 16 and 20weeks, a decline consistent in PE.

Conclusion: These data support a modest role for ADMA and related metabolites in the pathogenesis of hypertensive pregnancy.

Keywords: ADMA; Gestational hypertension; Longitudinal; Preeclampsia; Recurrent.