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Possible mechanisms for the increased ADMA concentrations include the involvement of the methionine-homocysteine pathway in the biosynthesis of ADMA and the homocysteine-mediated inhibition of ADMA metabolism by the enzyme DDAH [21], [22]

10.1186/1471-2482-13-S2-S40 [DOI] [PMC free article] [PubMed] [Google Scholar] Bilic M., Bumber Z., Blagaic A

Follow-up for outcomes commenced 1 month after the index date and continued until the occurrence of the outcome event, the last clinical encounter, death, or 1 year postindex date, whichever came first

The Journal of biological chemistry

If your vial has been left at room temperature for an extended period, the effective life may be shorter