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HelpTest ID ADMA Asymmetric Dimethylarginine, Plasma
Specimen Required
Patient Preparation: Fasting-overnight (12 hours)
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge and aliquot 1 mL of plasma into plastic vial.
2. Send specimen frozen.
Forms
If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.
Secondary ID
607697Useful For
Assessing the likelihood of future coronary events in patients with coronary heart disease, type II diabetes mellitus, or kidney disease
Prompting intervention and assessing improvements among subjects with elevated ADMA and hypercholesterolemia or type II diabetes mellitus
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Asymmetric dimethylarginine, PSpecimen Type
Plasma EDTASpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma EDTA | Frozen (preferred) | 90 days |
| Ambient | 7 days | |
| Refrigerated | 7 days |
Clinical Information
Asymmetric dimethylarginine (ADMA) is an independent risk factor for major adverse cardiovascular events.(1-7) ADMA inhibits nitric oxide (NO) synthesis and is elevated in diseases related to endothelial dysfunction including hypertension, hyperlipidemia, and type II diabetes mellitus. Elevation in ADMA and subsequent NO synthesis inhibition leads to vasoconstriction, reduced peripheral blood flow, and reduced cardiac output.
Elevated plasma ADMA confers a 4- to 6-fold increased risk of subsequent cardiovascular events or mortality among patients with acute coronary syndrome,(3) unstable angina,(4) type II diabetes mellitus,(5) end-stage renal disease,(6) coronary heart disease,(7) and peripheral artery disease.(1) Baseline ADMA remained a significant risk factor of adverse events even after adjusting for low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides, creatinine, and high-sensitivity C-reactive protein.
Plasma ADMA concentrations are lowered by rosuvastatin and atorvastatin, but not simvastatin in patients with hypercholesterolemia.(8) Addition of vildagliptin (Galvus) to metformin significantly reduced ADMA concentrations among patients with type II diabetes mellitus.(9)
Reference Values
≥18 years: 63-137 ng/mL
Reference values have not been established for patients who are <18 years of age
Cautions
No significant cautionary statements
Day(s) Performed
Thursday
Report Available
2 to 9 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82542