Elevated concentrations of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, are associated with endothelial dysfunction. Metabolic syndrome (MetS) is also a condition associated with impaired endothelial function. To test the hypothesis that lipid lowering treatment with a statin lowers ADMA levels, we investigated the effect of fluvastatin treatment on serum ADMA levels in patients with MetS.
A total of 85 hypercholesterolemic MetS patients (53 females, 32 males; mean age, 55.8 ± 9.1 years) were included in this prospective, randomized, controlled study. Patients were randomly assigned to either the treatment (n = 42) or control group (n = 43). Recommendations for lifestyle modification were provided to both groups. In addition, the patients in the treatment group received fluvastatin, extended release tablets, 80 mg/day, orally for 6 weeks. Serum levels of ADMA and lipids were assessed at baseline and at the completion of treatment. High performance liquid chromatography was used to measure serum ADMA concentrations.
In the fluvastatin group, there was a significant reduction in serum ADMA levels compared to baseline (from 1.57 ± 1.07 μmol/L to 1.17 ± 1.41 μmol/L, P < 0.05), whereas in the control group no significant change was observed (from 1.06 ± 0.46 μmol/L to 1.24 ± 1.38 μmol/L, P > 0.05). There was a statistically significant difference between the groups in terms of mean percent change from baseline (P = 0.047).
Fluvastatin treatment for hypercholesterolemia in patients with MetS is associated with a decrease in serum ADMA levels at 6 weeks. This finding is consistent with known beneficial effects of statin treatment on endothelial function in hypercholesterolemic patients.