Evaluation of symmetric and asymmetric dimethylarginine levels in cancer patients

Abstract Objectives Several studies have demonstrated that arginine may become a limiting factor in conditions characterized by rapid growth, such as malignancy. Given this requirement for arginine in malignant cells, arginine deprivation may be considered an adjunctive treatment approach for cancers unable to synthesize arginine. This study aimed to examine serum arginine and its derivatives in patients with cancer compared with a control group. Methods Serum samples obtained from patients followed up for gastrointestinal, breast, thyroid, soft-tissue, and skin cancer at the Surgical Oncology Clinic of Ankara Bilkent City Hospital between February and June 2026 were analyzed for symmetric dimethylarginine (SDMA), asymmetric dimethylarginine (ADMA), arginine, homoarginine, and citrulline levels. In addition, patients’ height, weight, age, sex, comorbidities, surgical status, neoadjuvant therapy status, and lengths of hospital and intensive care unit stays were assessed. Results Although no difference was observed between the groups regarding body mass index measurements (p>0.05), the mean age (p<0.001) and proportion of female patients (p<0.05) were higher in case group compared with the control group. In patients with cancer, ADMA (µmol/L) and SDMA (µmol/L) measurements were higher than those in the control group (p<0.001), whereas arginine (µmol/L), homoarginine (µmol/L), and citrulline (µmol/L) measurements were lower than those in the control group (p<0.001). Conclusions Given the advantages of serum arginine and its metabolites – such as practical measurement and rapid results – we believe they could be beneficial in the clinical monitoring and treatment of patients with certain types of cancer.