Asymmetric Dimethylarginine in COPD Exacerbation

Abstract

Objectives: Chronic obstructive pulmonary disease (COPD) is a disease with progressive airway limitation. The asymmetric dimethylarginine (ADMA) molecule is known to be effective in airway inflammation and remodeling. We investigated the relationship between ADMA and COPD, and its role in the course of the disease in cases with exacerbation.

Methods: This single-center study performed in our patient clinic included 56 patients (57.1% of males) with median age 67 (41-88) presented with COPD exacerbation and 26 sex-matched healthy controls. ADMA, white blood cell count, eosinophil, neutrophil, lymphocyte, C-reactive protein, fibrinogen, oxygen saturation%, and pulmonary function test values were compared.

Results: ADMA values were significantly higher (516.93 vs. 320.05 median, p<0.05) in the COPD group compared to the control group. No significant difference was demonstrated in ADMA concentrations according to Global Initiative for Chronic Obstructive Lung Disease Stages (p>0.05). In the receiver operating characteristic analysis to estimate the predictive power of COPD, the cutoff ADMA concentration >301 ng/ml was found to be able to distinguish COPD patients in all cases.

Conclusion: ADMA levels increase with complex mechanisms in COPD. It can be a significant indicator of the disease. However, more extensive research is needed for its use as a biomarker in severity and progression of COPD.

Keywords: Asymmetric dimethylarginine; Chronic obstructive pulmonary disease; Exacerbation.

Figure 1

The receiver operating characteristic (ROC) curve analysis made for the ability to estimate COPD disease in all cases; the area under curve (AUC) value was detected as 95% confidence interval (CI), 0.636 (0.522–0.739), p=0.03, for ADMA. The optimal cutoff value specified for ADMA was 301.4 ng/ml (with 87.5% sensitivity and 36% specificity, respectively) and was found to be statistically significant.