Association of elevated asymmetric dimethylarginine (ADMA) with subclinical carotid atherosclerosis in multiple sclerosis: A cross-sectional biomarker study

Multiple sclerosis (MS) is associated with an elevated risk of cardiovascular complications primarily due to endothelial dysfunction. Asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase, is a biomarker for endothelial dysfunction. This study aimed to examine the association between serum asymmetric dimethylarginine (ADMA) levels and carotid intima-media thickness (CIMT) in patients with MS compared with healthy controls. This study included 50 patients with MS and 50 healthy controls. Serum ADMA concentrations were quantified and CIMT was evaluated using Doppler ultrasonography. Statistical analyses included correlation and multivariate regression modeling. In this cross-sectional study, elevated levels of ADMA were found to be associated with increased subclinical carotid atherosclerosis in patients with MS. These findings suggest that ADMA may serve as a candidate biomarker for cardiovascular risk stratification. However, further prospective longitudinal studies are necessary to validate these findings and to establish the predictive value of ADMA in this population. Patients with MS exhibited significantly elevated ADMA levels (median: 15, 053 vs 8, 818 ng/L, P < .05) and increased CIMT (median: 0.60 [0.50-0.78] vs 0.50 [0.40-0.70] mm, P < .05) than controls. A positive correlation was observed between ADMA and CIMT (R = 0.56, r2 = 0.31, P < .01). In multivariate regression analysis, ADMA was the only significant independent predictor of CIMT (P < .001).