Test Catalog

Test Id : ADMA

Asymmetric Dimethylarginine, Plasma

Useful For
Suggests clinical disorders or settings where the test may be helpful

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
A short description of the method used to perform the test

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Asymmetric dimethylarginine, P

Aliases
Lists additional common names for a test, as an aid in searching

ADMA

Asymmetric dimethylarginine

Specimen Type
Describes the specimen type validated for testing

Plasma EDTA

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen (preferred) 90 days
Ambient 7 days
Refrigerated 7 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

> or =18 years: 63-137 ng/mL

Reference values have not been established for patients who are <18 years of age

Interpretation
Provides information to assist in interpretation of the test results

In patients with preexisting coronary conditions or at high risk for coronary events (diabetes, renal insufficiency), asymmetric dimethylarginine (ADMA) levels in the upper tertile, above 112 ng/mL, confer an increased risk for future coronary events.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Chu R, Yu D, Chu J, et al: Prognostic efficacy of circulating asymmetric dimtheylarginine in patients with peripheral arterial disease: A meta-analysis of prospective cohort studies. Vascular. 2018;26:322-330

2. Schulze F, Lenzen H, Hanefeld C, et al.: Asymmetric dimethylarginine is an independent risk factor for coronary heart disease: results from the multicenter Coronary Artery Risk Determination investigating the Influence of ADMA Concentration (CARDIAC) study. Am Heart J. 2006 Sep;152(3):493.e1-8

3. Cavusoglu E, Ruwende C, Chopra V, et al: Relationship of baseline plasma ADMA levels to cardiovascular outcomes at 2 years in men with acute coronary syndrome referred for coronary angiography. Coron Artery Dis. 2009;20:112-117

4. Krempl TK, Maas R, Sydow K, et al: Elevation of asymmetric dimethylarginine in patients with unstable angina and recurrent cardiovascular events. Eur Heart J. 2005;26:1846-1851

5. Cavusoglu E, Ruwende C, Chopra V, et al: Relation of baseline plasma ADMA levels to cardiovascular morbidity and mortality at two years in men with diabetes mellitus referred for coronary angiography. Atherosclerosis. 2010 May;210(1):226-231

6. Abedini S, Meinitzer A, Holme I, et al: Asymmetrical dimethylarginine is associated with renal and cardiovascular outcomes and all-cause mortality in renal transplant recipients. Kidney Int. 2010 Jan;77(1):44-50

7. Valkonen VP, Paiva H, Salonen JT, et al: Risk of acute coronary events and serum concentration of asymmetrical dimethylarginine. Lancet. 2001;358:2127-2128

8. Kurtoglu E, Sevket B, Sincer I, et al: Comparison of effects of Rosuvastatin versus Atorvastatin treatment on plasma levels of asymmetric dimethylarginine in patients with hyperlipidemia having coronary artery disease. Angiology. 2014;65:788-793

9. Cakirca M, Karatoprak C, Zorlu M, et al: Effect of vildagliptin add-on treatment to metformin on plasma asymmetric dimethylarginine in type 2 diabetes mellitus patients. Drug Des Devel Ther. 2014;8:239-243

10. Ravani P, Tripepi G, Malberti F, et al: Asymmetrical dimethylarginine predicts progression to dialysis and death in patients with chronic kidney disease: a competing risks modeling approach. J Am Soc Nephrol. 2005;16:2449-2455

11. Elesber AA, Solomon H, Lennon RJ, et al:  Coronary endothelial dysfunction is associated with erectile dysfunction and elevated asymmetric dimethylarginine in patients with early atherosclerosis. Eur Heart J. 2006 Apr;27(7):824-31

Method Description
Describes how the test is performed and provides a method-specific reference

Asymmetric dimethylarginine (ADMA) is separated and quantified by liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Thursday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 9 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82542

LOINC® Information

Test Id Test Order Name Order LOINC Value
ADMA Asymmetric dimethylarginine, P 80981-4
Result Id Test Result Name Result LOINC Value
Result LOINC Value Tooltip
83651 Asymmetric dimethylarginine, P 80981-4

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports