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Early Hum Dev. 2014 Apr;90(4):173-6. doi: 10.1016/j.earlhumdev.2014.01.010. Epub 2014 Feb 4.

Advanced intrauterine growth restriction is associated with reduced excretion of asymmetric dimethylarginine.

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  • 1Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy. Electronic address:
  • 2Department of Surgery, Section of Neonatal Intensive Care Unit and Puericulture, University of Cagliari, Cagliari, Italy.
  • 3Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy.



High blood levels of asymmetric dimethylarginine (ADMA) are associated with future development of adverse cardiovascular events. The ADMA/symmetric dimethylarginine (SDMA) ratio is a marker of ADMA catabolism, with a high ADMA/SDMA ratio being suggestive of reduced ADMA excretion.


This study aimed a) to verify the presence of a statistically significant difference between ADMA/SDMA ratio levels in a group of young adult subjects who were born preterm with an extremely low birth weight (ex-ELBW) and a group of healthy adults born at term and b) to seek correlations between ADMA/SDMA ratio levels in ex-ELBW and anthropometric and clinical parameters (gender, chronological age, gestational age, birth weight, and length of stay in the Neonatal Intensive Care Unit).


Thirty-seven ex-ELBW subjects (11 males [M] and 26 females [F], aged 17-28 years, mean age: 22.2 ± 1.8 years) were compared with 37 controls (11 M and 26 F). ADMA/SDMA ratio levels were assessed for each patient included in the study.


ADMA/SDMA ratio in ex-ELBW subjects was higher compared to controls (1.42 ± 0.31 vs 0.95 ± 0.14, p<0.002) and inversely correlated with birth weight (r=-0.68, p<0.0001) and gestational age (r=-0.54, p<0.0005).


ADMA catabolism is significantly decreased in ex-ELBW subjects compared to controls, underlining a probable correlation with restriction of intrauterine growth. These results suggest the onset of early circulatory dysfunction predictive of increased cardiovascular risk in ex-ELBW.

Copyright © 2014 Elsevier Ltd. All rights reserved.


Asymmetric dimethylarginine; Cardiovascular risk; Intrauterine growth restriction; Kidney; Symmetric dimethylarginine

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