Levels of Asymmetric Dimethylar Ginine and Risk of Neurovascular Diseases: A Systematic Review and Meta‐Analysis

Scope The purpose of this study was to provide clear evidence that reliably quantifies the association of Asymmetric dimethylarginine (ADMA) levels with the risk of neurovascular diseases. Methods and results The Pubmed, Web of Science, and Embase were systematically searched to identify eligible studies published until August 2024. A total of 31 eligible studies were identified. Pooled results indicated that patients with stroke yielded a higher ADMA level than healthy controls [standardized mean difference (SMD) = 1.02, 95% CI = 0.92–1.12, P = 0.001]. Subgroup analyses showed that geographical location, sample type, number of events and the proportion of male participants were statistically significant sources of heterogeneity. Similarly, a significant association with a pooled risk ratio (RR) of 1.60 (95% CI = 1.60–1.91) was shown between ADMA exposure and the risk of stroke from seven cohort studies. There was a statistically significant difference between ADMA level and small vessel disease (SVD) (SMD = 0.33, 95% CI = 0.07–0.58, p = 0.001). In addition, migraine patients tend to have elevated ADMA levels compared to healthy controls (SMD = 0.39, 95% CI = 0.11–0.67, P = 0.001). Conclusions Our results indicate that ADMA levels have significant effects in patients with stroke, SVD, and migraine.