Blood test predicts heart risk in diabetics

The presence of a naturally occurring enzyme in blood can help predict heart and kidney disease in type 1 or insulin dependent diabetics.The enzyme called asymmetrical dimethylarginine (ADMA) inhibits a compound involved in blood vessel dilation. Previous research has shown that elevated blood levels of ADMA reduce the ability of the blood vessels to widen, and are also linked to an increased risk of heart and blood vessel disease.Researchers in Denmark investigated the value of ADMA in predicting heart and kidney events in 397 type 1 diabetics with kidney disease and 175 diabetic controls without kidney disease. These patients were followed up for an average of 11 years with annual evaluation of kidney function. Among the type 1 diabetics with kidney disease, significantly more patients with ADMA levels above the average (43.4 per cent) than similar patients with ADMA levels below the average (19.4 per cent) suffered a fatal or non-fatal major cardiovascular event, such as a heart attack. It was also found that patients with ADMA levels above the average experienced a faster decline in kidney function than patients with lower ADMA levels. Patients with higher ADMA levels were more than three times as likely as patients with lower ADMA levels to develop end-stage renal disease, the most advanced form of kidney disease. Overall death rate was 67 per cent higher among patients with higher ADMA levels than among patients with lower ADMA levels. The findings suggest that plasma ADMA levels can predict cardiovascular events in patients with type 1 diabetic nephropathy. High ADMA levels also tend to contribute to increased risk of progressive diabetic kidney disease. This test can help doctors identify type 1 diabetics having a higher risk of heart and kidney disease.