TMAO is Associated with Mortality: Impact of Modestly Impaired Renal Function.
TMAO is Associated with Mortality: Impact of Modestly Impaired Renal Function.
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DOI：
10.1038/s41598-017-13739-9
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发表时间：
2017-10-23
影响因子：
4.6
通讯作者：
Dullaart RPF
中科院分区：
文献类型：
--
作者：
Gruppen EG;Garcia E;Connelly MA;Jeyarajah EJ;Otvos JD;Bakker SJL;Dullaart RPF
三甲胺-N-氧化物（TMAO）是一种微生物组相关的代谢产物，由肾脏清除并与肾功能相关。我们探讨了氧化三甲胺和全因死亡率之间的关系，并确定这种关联是否受到肾功能的影响。在PREVEND参与者中进行了一项前瞻性研究，以检查血浆TMAO与全因死亡率的相关性。在对5，469名参与者进行中位8.3年的随访后，322名受试者死亡。TMAO与年龄、体重指数、2型糖尿病呈正相关，与估计肾小球滤过率（eGFRcreatcysC）呈负相关（均P < 0.001）。TMAO最高与最低四分位数的受试者的死亡风险粗高1.86倍（P趋势< 0.001）。在调整几个危险因素后，TMAO仍然与全因死亡率相关[HR：1.36（95%CI，0.97-1.91），Ptrend = 0.016]。在进一步校正尿白蛋白排泄和eGFR后，这种相关性消失[HR：1.15（95% CI，0.81-1.64），Ptrend = 0.22]。TMAO与死亡率的相关性在粗分析以及年龄和性别校正分析中通过eGFR进行了修改（相互作用P = 0.002）。当参与者按肾功能分层时（eGFR < vs. ≥90 mL/min/1.73 m2），TMAO仅与eGFR <90 mL/min/1.73 m2的受试者的全因死亡率相关[校正HR：1.18（95%CI，1.02-1.36），P = 0.023]。总之，TMAO与全因死亡率相关，特别是在eGFR <90 mL/min/1.73 m2的受试者中。
Trimethylamine-N-Oxide (TMAO) is a microbiome-related metabolite that is cleared by the kidney and linked to renal function. We explored the relationship between TMAO and all-cause mortality, and determined whether this association was modified by renal function. A prospective study was performed among PREVEND participants to examine associations of plasma TMAO with all-cause mortality. After median follow-up of 8.3 years in 5,469 participants, 322 subjects died. TMAO was positively associated with age, body mass index, type 2 diabetes mellitus and inversely with estimated glomerular filtration rate (eGFRcreatcysC)(all P < 0.001). Subjects in the highest versus lowest TMAO quartile had a crude 1.86-fold higher mortality risk (Ptrend < 0.001). After adjustment for several risk factors, TMAO remained associated with all-cause mortality [HR:1.36 (95% CI, 0.97–1.91),Ptrend = 0.016]. This association was lost after further adjustment for urinary albumin excretion and eGFR [HR:1.15 (95% CI, 0.81–1.64),Ptrend = 0.22]. The association of TMAO with mortality was modified by eGFR in crude and age- and sex-adjusted analyses (interaction P = 0.002). When participants were stratified by renal function (eGFR < vs. ≥90 mL/min/1.73 m2), TMAO was associated with all-cause mortality only in subjects with eGFR <90 mL/min/1.73 m2 [adjusted HR:1.18 (95% CI, 1.02–1.36),P = 0.023]. In conclusion, TMAO is associated with all-cause mortality, particularly in subjects with eGFR <90 mL/min/1.73 m2.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
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作者：
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发表时间：
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