ADMA in patients with peripheral arterial occlusive disease

In patients with peripheral arterial occlusive disease ADMA levels are increasingly elevated depending upon the clinical stage of the disease: By comparison with age-matched subjects with normal vascular function, patients with intermittent claudication (Leriche-Fontaine stage II) had a two-fold elevation, patients with rest pain (Leriche-Fonntaine stage III) had a three-fold elevation, and patients with peripheral necrosis and gangrene (Leriche-Fontaine stage IV) had a 3.5-fold elevation of circulating ADMA levels (Figure 15) [7].
In the same study, a stage-dependent reduction of urinary NO metabolite excretion was reported, which - like clinical symptoms of intermittent claudication - is reversible by administration of L-arginine [49].

Figure 15. ADMA plasma concentration in patients with peripheral arterial occlusive disease (PAOD) in relationship to the severity of their disease, by comparison to young (mean age, 34 years) and old (mean age, 68 years) healthy subjects (Data from [7]).