Association Of Metabolic Syndrome With Endothelial Progenitor Cell Levels And Asymmetric Dimethylarginine In Prediabetes

Background: Metabolic syndrome is a cluster of cardiometabolic risk factors associated with endothelial dysfunction and increased cardiovascular risk. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, is associated with reduced nitric oxide (NO) production. ADMA has evolved as a possible novel marker of endothelial dysfunction and atherosclerosis in humans. Endothelial progenitor cells (EPCs) have recently been considered as a potential novel biomarker of vascular integrity, atherosclerosis and cardiovascular risk.Aim: The purpose of the study was to investigate the association between metabolic syndrome with ADMA and EPC levels in individuals with prediabetes.Materials - Methods: Fifty-three subjects with newly diagnosed prediabetes free from overt cardiovascular or renal disease were enrolled. Flow cytometry was used to quantify EPCs (CD34+VEGFR-2+CD133+). Traditional risk factors, high-sensitivity C-reactive protein (hs-CRP), homeostasis model assessment of insulin resistance (HOMA-IR) and anthropometric parameters were recorded.Results: At the univariate analysis, metabolic syndrome was significantly and positively associated with hsCRP (6.50 +/- 5.86 vs 2.93 +/- 3.28 mg/L, p=0.017), insulin (29.0 +/- 19.5 vs 16.2 +/- 2.4 mu mol/L, p=0.04), HOMA-IR (7.26 +/- 4.64 vs 4.04 +/- 0.63, p=0.015), ADMA (0.79 +/- 0.16 vs 0.66 +/- 0.11 mu mol/L, p=0.009) while a negative association was observed between metabolic syndrome and C-peptide levels (2.86 +/- 2.34 vs 3.71 +/- 1.64 ng/mL, p=0.038). No statistical difference was documented between metabolic syndrome and EPCs (p=0.634).However, at the multivariate ordinal logistic regression analysis, only ADMA (increment=0.1 mu mol/L, OR=6.30, p=0.002) and hs-CRP. (increment=1mg/L, OR=1.78, p=0.017) retained their statistical significance.Conclusions: The presence of MS in prediabetes probably induces endothelial dysfunction and increased cardiovascular risk through its association with inflammation and the increased levels of ADMA.