Betaine and secondary events in an acute coronary syndrome cohort.
Betaine and secondary events in an acute coronary syndrome cohort.
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DOI：
10.1371/journal.pone.0037883
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Chambers ST
中科院分区：
文献类型：
--
作者：
Lever M;George PM;Elmslie JL;Atkinson W;Slow S;Molyneux SL;Troughton RW;Richards AM;Frampton CM;Chambers ST
甜菜碱不足与代谢综合征患者不利的血管风险特征相关我们调查了急性冠脉综合征患者中甜菜碱不足和继发性事件之间的关系。在急性冠状动脉事件后出院后4个月收集血浆（531）和尿液（415）样本。在832天的中位随访期内，记录了死亡（34例）、继发性急性心肌梗死（MI）（70例）和因心力衰竭住院（45例）事件。尿甜菜碱排泄量最高和最低的五分位数与心力衰竭风险相关（p = 0.0046，p = 0.013，与中间60%相比），但与随后的急性MI无关。 血浆甜菜碱水平最低的五分之一与随后的急性MI相关（p = 0.014），血浆甜菜碱水平最高的五分之一与心力衰竭相关（p = 0.043），尤其是在糖尿病患者中（p<0.001）。 二甲基甘氨酸（甜菜碱代谢物）和血浆同型半胱氨酸的前五分位浓度均与急性心肌梗死（p = 0.004，<0.001）、心力衰竭（p = 0.027，p<0.001）和生存率（p<0.001，p<0.001）这三种结局相关。 高同型半胱氨酸与>60%的受试者的高或低甜菜碱排泄相关（p = 0.017）。 中位NT-proBNP浓度在血浆甜菜碱浓度的中间五分位数中最低（p = 0.002）。 甜菜碱不足表明继发性心力衰竭和急性心肌梗死的风险增加。它与高同型半胱氨酸的相关性可能部分解释了叶酸补充剂令人失望的结果。在某些患者中，尤其是糖尿病患者，血浆甜菜碱升高也表明风险增加。
Betaine insufficiency is associated with unfavourable vascular risk profiles in metabolic syndrome patients. We investigated associations between betaine insufficiency and secondary events in acute coronary syndrome patients. Plasma (531) and urine (415) samples were collected four months after discharge following an acute coronary event. Death (34), secondary acute myocardial infarction (MI) (70) and hospital admission for heart failure (45) events were recorded over a median follow-up of 832 days. The highest and lowest quintiles of urinary betaine excretion associated with risk of heart failure (p = 0.0046, p = 0.013 compared with middle 60%) but not with subsequent acute MI. The lowest quintile of plasma betaine was associated with subsequent acute MI (p = 0.014), and the top quintile plasma betaine with heart failure (p = 0.043), especially in patients with diabetes (p<0.001). Top quintile plasma concentrations of dimethylglycine (betaine metabolite) and top quintile plasma homocysteine both associated with all three outcomes, acute MI (p = 0.004, <0.001), heart failure (p = 0.027, p<0.001) and survival (p<0.001, p<0.001). High homocysteine was associated with high or low betaine excretion in >60% of these subjects (p = 0.017). Median NT-proBNP concentrations were lowest in the middle quintile of plasma betaine concentration (p = 0.002). Betaine insufficiency indicates increased risk of secondary heart failure and acute MI. Its association with elevated homocysteine may partly explain the disappointing results of folate supplementation. In some patients, especially with diabetes, elevated plasma betaine also indicates increased risk.
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DOI：
10.1186/1550-2783-6-7
发表时间：
2009-02-27
影响因子：
5.1
作者：
Hoffman, Jay R.;Ratamess, Nicholas A.;Faigenbaum, Avery D.
通讯作者：
Faigenbaum, Avery D.
影响因子：
2.8
作者：
Lever, Michael;Atkinson, Wendy;George, Peter M.
通讯作者：
George, Peter M.
影响因子：
5
作者：
LEVER, M;SIZELAND, PCB;CHAMBERS, ST
通讯作者：
CHAMBERS, ST
影响因子：
7.1
作者：
Konstantinova, Svetlana V.;Tell, Grethe S.;Ueland, Per M.
通讯作者：
Ueland, Per M.
补充甜菜碱可减轻载脂蛋白 E 缺陷小鼠的动脉粥样硬化病变
影响因子：
5
作者：
Lv, Shiwei;Fan, Ruixin;Zhu, Huilian
通讯作者：
Zhu, Huilian