Association between asymmetric dimethylarginine level and central obesity among patients with acute myocardial...

Asymmetric dimethylarginine (ADMA), a competitive inhibitor of endothelial nitric oxide synthase (eNOS), has been implicated in atherosclerotic cardiovascular disease. However, the prognostic significance of baseline ADMA in the context of central obesity among patients with acute myocardial infarction (AMI) remains insufficiently characterized.

This study aimed to investigate whether central obesity (CO) is associated with elevated ADMA levels among patients with AMI in the Gaza Strip, Palestine.

A comparative cross-sectional study was conducted at four governmental hospitals in the Gaza Strip. One hundred and twenty patients with a confirmed diagnosis of AMI aged 30-65 years were recruited via convenience sampling between January 2023 and October 2023. Anthropometric parameters, including Body Mass Index (BMI) and Waist Circumference (WC), biochemical measurements such as ADMA, homocysteine (Hcy), and lipid profile, and lifestyle factors were assessed. Group differences were evaluated using independent-samples t-tests. Pearson correlations and Multiple linear regression were employed to explore inter-variable relationships.

Of 120 AMI patients, 102 (85.0%) were male, and 18 (15.0%) were female (mean age 53.49 ± 7.35 years). Central obesity (WC >102 cm in men; >88 cm in women) was present in 53.3% of participants. Statistically significant differences between the centrally obese and non-obese groups were observed for total cholesterol (P = 0.030), triglycerides (P = 0.048), and HDL-c (P = 0.043). ADMA and Hcy levels were significantly higher in the centrally obese group than in the non-obese group (differences: 35.1 ng/mL and 7.7 µmol/L, respectively; P = 0.040 and P = 0.009). Multiple Linear Regression identified WC as the only significant independent predictor of ADMA (β = 1.22, 95% CI 0.003- 2.445, P = 0.049).

WC was significantly associated with elevated ADMA levels in patients with AMI. Given the cross-sectional design, these findings should be regarded as preliminary, and further longitudinal studies are needed to confirm whether central obesity contributes to elevated ADMA and cardiovascular risk.