ADMA In OSA

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ADMA in OSA It is now well established that OSA is a cardiovascular risk factor, and that ADMA has the potential to exacerbate cardiovascular disease. But does OSA influence ADMA levels? Many studies show increases in ADMA levels in OSA patients; Barcelo et al measured plasma ADMA in 23 OSA patients and found it significantly higher (1.17 μmol/L) compared to control (0.87 μmol/L, P<0.01) (55). Ozkan et al also found that ADMA levels were higher in OSA patients but levels did not reach statistical significance (56). When treated with CPAP for 4 weeks, patients with OSA had lower ADMA levels and improved forearm mediated dilation (FMD) (57). It is unclear how OSA increases ADMA levels but apparently CPAP treatment can decrease its levels. 1- Oxidative stress Oxidative stress results from an imbalance in oxidant production and antioxidant defense mechanisms; this means that either the overproduction of reactive oxygen and nitrogen species (ROS/RNS) and / or a decreased antioxidant capacity leads to …show more content…

Different studies show lower levels of circulating NO in OSA, for example by the reduced levels of serum nitrite/nitrate (byproducts of normal NO metabolism) in OSA subjects 63.1 μM in (82) . Many mechanisms have been suggested for endothelial dysfunction due to OSA or IH including [1] interaction on NO and ROS forming peroxynitrite, [2] uncoupling of eNOS, [3] decreased endothelial expression of eNOS and [4] increased levels of endogenous eNOS inhibitors such as ADMA (83). The short half-life and large volume of distribution of peroxynitrite could account for the similar levels of nitrotyrosine levels in OSA and healthy subjects (84, 85). However, Jelic et al. found increased expression of nitrotyrosine staining in endothelial cells from OSA patients

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