Objective To observe the changes of serum levels of L - homoarginine and asymmetric dimethylarginine, to investigate their correlations with cardiovascular disease in patients with type 1 diabetes mellitus. Methods A total of 89 patients with type 1 diabetes mellitus were selected as observation group in People's Hospital of Baoji from 2010 to 2012,and a total of 90 healthy people were selected as control group at the same time;according to the incidence of cardiovascular events during the 2 - year fellow - up,patients of observation group were divided into three subgroups:A group( with severe cardiovascular events,n = 16),B group( with general cardiovascular events,n = 18),C group( without cardiovascular events,n = 55). Serum levels of L - homoarginine,asymmetric dimethylarginine and L - arginine at admission were compared between observation group and control group,while serum levels of L - homoarginine,asymmetric dimethylarginine,L -arginine,hs - CRP,TNF - α,IL - 6 were compared among A group,B group and C group,correlations between serum L -homoarginine,asymmetric dimethylarginine levels and incidence of cardiovascular events,serum levels of hs - CRP,TNF - αand IL - 6 were analyzed. Results No statistically significant differences of L - arginine was found between control group and observation group(P > 0. 05),while serum L - homoarginine level of observation group was statistically significantly lower than that of control group,serum asymmetric dimethylarginine level of observation group was statistically significantly higher than that of control group(P < 0. 05). No statistically significant differences of L - arginine was found among A group,B group and C group(P > 0. 05),while serum L - homoarginine level of B group was statistically significantly lower than that of C group, serum levels of asymmetric dimethylarginine,hs - CRP,TNF - α and IL - 6 of B group were statistically significantly higher than those of C group(P < 0. 05);serum L - homoarginine level of A group was statistically significantly lower than that of B group, C group,respectively,while serum levels of asymmetric dimethylarginine,hs - CRP,TNF - α and IL - 6 of A group were statistically significantly higher than those of B group and C group(P < 0. 05). Pearson correlation analysis showed that,serum L - homoarginine level was negatively correlated with incidence of cardiovascular events(r = - 0. 458,P = 0. 000),serum hs -CRP level(r = - 0. 389,P = 0. 005),serum TNF - α level( r = - 0. 235,P = 0. 023) and serum IL - 6 level( r =- 0. 224,P = 0. 033 ),respectively;serum asymmetric dimethylarginine level was positively correlated with incidence of cardiovascular events(r = 0. 421,P = 0. 001),serum hs - CRP level(r = 0. 302,P = 0. 003),serum TNF - α level(r =0. 265,P = 0. 031)and serum IL - 6 level(r = 0. 228,P = 0. 032),respectively. Conclusion The serum L - homoarginine level of patients with type 1 diabetes mellitus is significantly lower,and is negatively correlated with the incidence of cardiovascular events;while serum asymmetric dimethylarginine level of patients with type 1 diabetes mellitus is significantly higher, and is positively correlated with the incidence of cardiovascular events; L - homoarginine and asymmetric dimethylarginine can cause endothelial dysfunction through affecting the NO production,and eventually induce cardiovascular disease.%目的：观察1型糖尿病患者 L -高精氨酸（L - HArg）和不对称性二甲基精氨酸（ADMA）水平变化，探讨其与心血管疾病的关系。方法选取2010—2012年宝鸡市人民医院收治的1型糖尿病患者89例作为观察组，另选取同期体检健康者90例作为对照组。比较两组受试者入院时血清 L - HArg、ADMA、L -精氨酸（L - Arg）水平。随访2年，将观察组患者按心血管事件发生情况分为严重心血管事件组（n =16）、一般心血管事件组（n =18）和无心血管事件组（n =55）3个亚组，比较3个亚组患者血清 L - HArg、ADMA、L - Arg 及超敏 C 反应蛋白（hs - CRP）、肿瘤坏死因子α（TNF -α）、白介素6（IL -6）水平，并分析血清 L - HArg、ADMA 水平与心血管事件发生率、hs -CRP、TNF -α、IL -6的相关性。结果两组受试者血清 L - Arg 水平比较，差异无统计学意义（P >0.05）；观察组患者血清 L - HArg 水平低于对照组，血清 ADMA 水平高于对照组（P <0.05）。3亚组患者血清 L - Arg 水平比较，差异无统计学意义（P >0.05）；一般心血管事件组患者血清 L - HArg 水平低于无心血管事件组，血清 ADMA 及 hs - CRP、TNF -α、IL -6水平高于无心血管事件组（P <0.05）；严重心血管事件组患者血清 L - HArg 水平低于一般心血管事件组和无心血管事件组，血清 ADMA 及 hs - CRP、TNF -α、IL -6水平高于一般心血管事件组和无心血管事件组（P <0.05）。Pearson 相关性分析结果显示，血清 L - HArg 水平与心血管事件发生率、血清 hs - CRP、TNF -α、IL -6水平呈负相关（ r 值分别为-0.458、-0.389、-0.235、-0.224，P 值分别为0.000、0.005、0.023、0.033），血清ADAM 水平与心血管事件发生率、血清 hs - CRP、TNF -α、IL -6水平呈正相关（r 值分别为0.421、0.302、0.265、0.228，P 值分别为0.001、0.003、0.031、0.032）。结论1型糖尿病患者血清 L - HArg 水平较低，其与患者心血管事件发生率呈负相关；1型糖尿病患者血清 ADMA 水平较高，其与患者心血管事件发生率呈正相关；二者均可通过影响一氧化氮的合成而引发血管内皮功能紊乱，最终诱发心血管疾病。
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