Increased plasma levels of asymmetric dimethylarginine and soluble CD40 ligand in patients with sleep apnea

Respiration. 2009;77(1):85-90. doi: 10.1159/000165630. Epub 2008 Oct 22.


Background: Cardiovascular (CV) diseases are a leading cause of mortality and they are frequent in patients with the obstructive sleep apnea syndrome (OSAS).

Objectives: In this study we investigated if OSAS influences CV function independently of other CV risk factors frequently present in these patients (e.g. obesity, high blood pressure).

Methods: We compared plasma markers of endothelial dysfunction, asymmetric dimethylarginine (ADMA) and endothelin-1 (ET-1), and atherosclerosis progression (soluble fraction of the CD40 ligand, sCD40L) in OSAS patients with (n = 23) and without (n = 18) concurrent CV risk factors, as well as in healthy subjects (n = 23).

Results: Plasma ADMA (p < 0.01) and sCD40L (p < 0.05) were abnormally increased in patients with OSAS versus healthy controls, but they were not influenced by the presence or absence of CV risk factors in OSAS. ET-1 levels were not different between the three groups of subjects studied.

Conclusions: OSAS is associated with endothelial injury and atherosclerosis progression independently of other CV risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arginine / analogs & derivatives*
  • Arginine / blood
  • Atherosclerosis / blood*
  • CD40 Ligand / blood*
  • Cardiovascular Diseases / complications
  • Case-Control Studies
  • Endothelin-1 / blood*
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Sleep Apnea, Obstructive / blood*
  • Sleep Apnea, Obstructive / complications


  • Endothelin-1
  • CD40 Ligand
  • N,N-dimethylarginine
  • Arginine