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Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp useful biomarker for detecting individuals in the early stages of kidney dysfunction and for determining their risk for developing CVD. 7 To date, most experimental and epidemiological studies have focused on the effect of tobacco smoke on ADMA levels only. The first study of the influence of tobacco smoke on ADMA levels was performed using animal models and demonstrated an increase in ADMA concentrations in the endothelial cells of rabbits after prolonged exposure to nicotine. 8 Jiang et al 9 observed a significant increase in ADMA concentrations in rat plasma following a 4-week administration of nicotine in doses of 5 mg · kg −1 · day −1 , and they suggested that nicotine models the metabolic pathway of ADMA in cells by activating the alpha7 nicotinic acetylcholine receptor. However, studies based on the culture of human endothelium-derived EAhy 926 cells produced divergent results. Incubation of cells within 48 h with condensate of tobacco smoke at concentrations of 1.0 and 10.0 mg/L n the past decade, there has been increased interest in new markers of cardiovascular diseases (CVDs). These new markers of CVD risk include 2 metabolites of L-arginine: asymmetric and symmetric dimethylarginine (ADMA and SDMA, respectively). The toxic effect of tobacco smoke is multidirectional, but the mechanism of its action is not completely clear. 1-5 One mechanism may be explained by the adverse effect of tobacco smoke on the concentration of newly discovered cardiovascular risk factors, including ADMA and SDMA, which are metabolites of L-arginine. Increased plasma concentration of ADMA, which is an endogenous inhibitor of endothelial nitric oxide (NO) synthase, is a strong and independent predictor of morbidity and overall mortality of CVD in healthy women and the general population, as well as in patients with kidney insufficiency, ischemic heart disease, peripheral vascular disease, chronic heart failure, idiopathic pulmonary hypertension, and diabetes. 6 SDMA does not inhibit NO synthase, but may be a Background: Tobacco smoking is one of the most important risk factors for cardiovascular disease (CVD) and few biomarkers have been linked to the increased risk of CVD and tobacco smoking. Tobacco smoke has been shown to elevate the plasma levels of asymmetric dimethylarginine (ADMA), a metabolite of L-arginine and an endogenous inhibitor of endothelial nitric oxide synthase. The other potential biomarker that has not been studied to date is L-homoarginine, a homolog of L-arginine. The aim of this study was to evaluate the effects of cigarette smoking on L-homoarginine and other CVD biomarkers.