Effect of l-arginine, asymmetric dimethylarginine, and symmetric dimethylarginine on ischemic heart disease risk: A Mendelian randomization study

Am Heart J. 2016 Dec:182:54-61. doi: 10.1016/j.ahj.2016.07.021. Epub 2016 Aug 26.

Abstract

Background: l-arginine is a commonly consumed dietary conditional essential amino acid found in food items and supplements, which is closely related to asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). l-arginine is thought to increase nitric oxide and be cardioprotective, whereas ADMA and SDMA may inhibit nitric oxide synthesis and increase cardiovascular disease risk. Unexpectedly, l-arginine increased mortality in a small trial. To clarify the effects of these potential targets of intervention, we assessed the risk of ischemic heart disease (IHD) by genetically determined l-arginine, ADMA, and SDMA.

Methods: Single nucleotide polymorphisms (SNPs) contributing to l-arginine, ADMA, and SDMA, at genome-wide significance, were applied to the CARDIoGRAMplusC4D 1000 Genomes-based genome-wide association study IHD case (n=60,801, ~70% myocardial infarction)-control (n=123,504) study. We obtained unconfounded estimates using instrumental variable analysis by combining the Wald estimators for each SNP, taking into account any correlation between SNPs using weighted generalized linear regression.

Results: Higher l-arginine was associated with higher risk of IHD (odds ratio [OR] 1.18 per SD increase, 95% CI 1.03-1.36) and of myocardial infarction (OR 1.29, 95% CI 1.10-1.51), based on 2 SNPs from MED23. Symmetric dimethylarginine had an OR of 1.07 per SD (95% CI 0.99-1.17) for IHD based on 5 SNPs from AGXT2. Asymmetric dimethylarginine had and OR of 1.08 per SD (95% CI 0.99-1.19) for IHD based on 4 SNPs from DDAH1.

Conclusion: l-arginine could possibly cause IHD. Given that l-arginine occurs in many common dietary items, investigation of its health effect is required.

MeSH terms

  • Arginine / analogs & derivatives
  • Arginine / genetics*
  • Female
  • Genome-Wide Association Study
  • Humans
  • Male
  • Mediator Complex / genetics*
  • Mendelian Randomization Analysis
  • Myocardial Infarction / genetics*
  • Polymorphism, Single Nucleotide
  • Transaminases / genetics*

Substances

  • MED23 protein, human
  • Mediator Complex
  • symmetric dimethylarginine
  • N,N-dimethylarginine
  • Arginine
  • Transaminases
  • Alanine-glyoxylate transaminase