Abstract：Objective: To observe the correlation between the improvement of clinical symptoms and analyze the factors such as symmetric dimethylarginine and arginine by detecting the levels of asymmetric dimethylarginine and phenylalanine in the blood of children with phenylketonuria and to analyze the predictive value of the disease control in patients with phenylketonuria. Methods: Ninety-six children with PKU who were regularly reexamined in Chengde Maternal and Child Health Hospital from September 2016 to March 2019 were selected. The concentration of phenylalanine (Phe) in the blood was detected by high performance liquid chromatography. Patients were divided into a well-controlled group (Phe240~600μmol/L) and a poorly-controlled group (Phe>600μmol/L) considering the control level of phenylalanine; another 100 healthy children were selected and made the control group. The clinical data and laboratory indicators of the three groups of children were compared using high-performance liquid chromatography. The detection covers PHE, symmetric dimethylarginine(SDMA), asymmetric dimethylarginine (ADMA), arginine (ARG), total homocysteine (HCY). Automatic biochemical detector was used to detect serum creatinine (Serum creatinine, SCR) fine Amino acid (Arginine, ARG), triglyceride (TG), total cholesterol (Totalcholesterol, TC), etc., and the clinical symptoms and intelligence scores of children were recorded; the correlation between ADMA and Phe, intelligence scores and other indicators was analyzed; multifactorial logistic regression analysis of independent related factors affecting children's intelligence development was conducted. Results:Compared with the control group, the intelligence score, ADMA, SDMA, Arg, Hcy water of PKU children were significantly lower than the control group, with statistical differences (P<0.05); compared with the poorly controlled group, the ADMA, SDMA, ARG levels and intelligence scores of the well-controlled group were significantly increased, with statistical differences (P<0.05); DMA, SDMA, ARG and HCY were the main factors affecting the concentration of phenylalanine (P<0.05). Among them, ADMA, SDMA, and ARG were negatively correlated with phenylalanine concentration, and positively correlated with intelligence scores. The correlation coefficients were 0.6, 0.7, and 0.4, respectively. Multivariate logistic regression analysis shows that high PHE level (OR=1.952) is an independent related factor that affects intellectual development (P<0.05), while older age (OR=1.074) and high ADMA level (OR=1.556) are protective factors for children's intellectual development (P<0.05). Conclusion: ADMA can be used as an emerging indicator for evaluating dietary metabolism control in children with PKU, and can effectively predict children's intellectual development.
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2021, Vol. 27 
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