Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low-Normal Ankle-Brachial Index
Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low-Normal Ankle-Brachial Index
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DOI：
10.1161/jaha.117.006604
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发表时间：
2017-09-01
影响因子：
5.4
通讯作者：
Ferrucci, Luigi
中科院分区：
文献类型：
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作者：
AlGhatrif, Majd;Zane, Ariel;Ferrucci, Luigi
背景：肌肉线粒体能量产生较低可能会导致外周动脉疾病患者的步行耐力受损。与较高的 ABI 相比，0.91 至 1.10 的临界踝臂指数 (ABI) 与较差的步行耐力相关。我们假设，在没有外周动脉疾病的情况下，较低的 ABI 与较低的线粒体能量产生有关。 方法和结果 - 我们检查了参与巴尔的摩纵向衰老研究的 363 名男性和女性，其 ABI 在 0.90 至 1.40 之间。通过左大腿磷磁共振波谱测量的运动后磷酸肌酸恢复率常数（kPCr）来评估肌肉线粒体能量产生。运动后磷酸肌酸恢复率常数较低反映了线粒体能量产生的减少。参与者的平均年龄为 71 +/- 12 岁。共有 18.4% 的人患有糖尿病，4% 的人目前吸烟，40% 的人以前吸烟。与ABI为1.11至1.40的参与者相比，ABI为0.90至1.10的参与者运动后磷酸肌酸恢复率常数显着较低（19.3 vs 20.8 ms(-1)，P=0.015）。在调整年龄、性别、种族、吸烟状况、糖尿病、体重指数和胆固醇水平后，这种差异仍然显着（P=0.028）。同样，运动后磷酸肌酸恢复率常数与 ABI 作为连续变量呈线性相关，ABI 范围为 0.90 至 1.40（标准化系数 = 0.15，P = 0.003）和 1.1 至 1.4（标准化系数 = 0.12，P = 0.0405）。结论 - ABI 为 0.90 至 1.10 与较低的线粒体相关。能源产量相比，ABI 为 1.11 至 1.40。这些数据表明，即使在临床可接受的正常 ABI 定义范围内，较低的 ABI 值与线粒体活性受损也存在不利关联。需要进一步研究以确定对 ABI 为 0.90 至 1.10 的人进行干预是否可以预防随后的功能衰退。
Background-Lower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle-brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher ABI. We hypothesized that in the absence of peripheral arterial disease, lower ABI is associated with lower mitochondrial energy production.Methods and Results-We examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an ABI between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post-exercise phosphocreatine recovery rate constant (kPCr) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post-exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production. The mean age of the participants was 71 +/- 12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an ABI of 1.11 to 1.40, those with an ABI of 0.90 to 1.10 had significantly lower post-exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms(-1), P=0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels (P=0.028). Similarly, post-exercise phosphocreatine recovery rate constant was linearly associated with ABI as a continuous variable, both in the ABI ranges of 0.90 to 1.40 (standardized coefficient=0.15, P=0.003) and 1.1 to 1.4 (standardized coefficient=0.12, P=0.0405).Conclusions-An ABI of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an ABI of 1.11 to 1.40. These data demonstrate adverse associations of lower ABI values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal ABI. Further study is needed to determine whether interventions in persons with ABIs of 0.90 to 1.10 can prevent subsequent functional decline.