Plasma levels of trimethylamine-N-oxide are confounded by impaired kidney function and poor metabolic control
Plasma levels of trimethylamine-N-oxide are confounded by impaired kidney function and poor metabolic control
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DOI：
10.1016/j.atherosclerosis.2015.10.091
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发表时间：
2015-12-01
期刊：
影响因子：
5.3
通讯作者：
von Eckardstein, Arnold
中科院分区：
文献类型：
--
作者：
Mueller, Daniel M.;Allenspach, Martina;von Eckardstein, Arnold
背景：人体摄入磷脂酰胆碱、L肉碱或甜菜碱后，肠道微生物区系与肝酶共同作用形成三甲胺-N-氧化物。血浆TMAO水平升高与心血管风险增加和其他疾病相关。同时甜菜碱和胆碱本身也与心血管风险增加有关。方法：采用一种新的LC-HRMS方法测定339例冠状动脉造影术患者血浆中甜菜碱、甜菜碱和胆碱的浓度。结果：男性甜菜碱浓度显著高于女性(42.0vs.35.9umol/L；p<；0.001)。糖尿病患者血浆氧化三甲胺浓度高于正常血糖患者(2.39mU/L)，而甜菜碱和胆碱浓度则高于正常血糖患者(p=0.001)；有代谢综合征患者高于非代谢综合征患者(2.37mU/L和1.43mU/L；p=0.002)。血浆氧化三甲胺或胆碱浓度随肾功能下降而显著升高(Spearman‘s Rho：-0.281；p<；0.001)。然而，血浆TMAO或甜菜碱水平与8年随访期间的心肌梗死病史、冠状动脉造影评估的存在冠心病或心血管事件无关。有急性心肌梗死病史的患者血浆胆碱水平显著低于无急性心肌梗死病史的患者(10.0vs.10.8mU/L；P=0.045)。结论：血浆TMAO水平与肾功能受损和代谢控制不良有关，但与冠心病的病史、症状或事件的发生率无关。(C)2015爱思唯尔爱尔兰有限公司。保留所有权利。
Background: After ingestion of phosphatidylcholine, L-carnitine or betaine, trimethylamine-N-oxide (TMAO) is formed by gut microbiota and liver enzymes. Elevated TMAO plasma levels were associated with increased cardiovascular risk and other diseases. Also betaine and choline itself were recently associated with increased cardiovascular risk.Methods: A newly developed LC-HRMS method was applied to measure the plasma concentrations of TMAO, betaine and choline in a cohort of 339 patients undergoing coronary angiography for the evaluation of suspected coronary artery disease.Results: Betaine concentrations in males were significantly higher than in females (42.0 vs. 35.9 mu mol/L; p < 0.001). Plasma concentrations of TMAO but not of betaine or choline were higher in patients with diabetes compared to euglycemic patients (2.39 vs. 0.980 mu mol/L; p = 0.001) as well as in patients with metabolic syndrome as compared to patients without metabolic syndrome (2.37 vs. 1.43 mu mol/L; p = 0.002). Plasma concentrations of TMAO or choline increased significantly with decreasing renal function (Spearman's rho: -0.281; p < 0.001). However, plasma levels of TMAO or betaine were associated with neither a history of myocardial infarction nor the angiographically assessed presence of coronary heart disease, nor incident cardiovascular events during 8 years of follow-up. Plasma levels of choline were significantly lower in patients with a history of acute myocardial infarction as compared to those without such history (10.0 vs. 10.8 mu mol/L; p = 0.045).Conclusions: Plasma levels of TMAO are confounded by impaired kidney function and poor metabolic control but are not associated with the history, presence or incidence of symptoms or events of coronary heart disease. (C) 2015 Elsevier Ireland Ltd. All rights reserved.