Acetylglutamine Differentially Associated with First-Time Versus Recurrent Stroke.
Acetylglutamine Differentially Associated with First-Time Versus Recurrent Stroke.
复制标题
乙酰谷氨酰胺与首次中风和复发性中风的相关性存在差异。
DOI：
10.1007/s12975-023-01181-1
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发表时间：
2023
影响因子：
6.9
通讯作者：
Kimberly,WTaylor
中科院分区：
文献类型：
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作者：
Kijpaisalratana,Naruchorn;Ament,Zsuzsanna;Patki,Amit;Bhave,VarunM;Jones,AlanaC;GarciaGuarniz,Ana-Lucia;Couch,CatharineA;Cushman,Mary;Long,DLeann;Irvin,MRyan;Kimberly,WTaylor
大约四分之一的中风发生在有中风史的人身上。尽管在二级卒中预防方面取得了进展，但卒中复发的长期风险仍未改变。本研究的目的是确定与卒中复发相关的代谢物风险标志物。我们在卒中病例队列研究中，通过液相色谱-串联质谱法对基线血浆中的162种代谢物进行了有针对性的代谢组学分析，该研究属于卒中地理和种族差异的原因（REGARDS）研究，该研究是一项观察性队列研究，纳入了2003-2007年登记的30,239名年龄在45岁及以上的个体。加权Cox比例风险模型使用代谢物与既往卒中基线之间的相互作用项（是或否）来确定代谢物对首次卒中和复发卒中有不同影响。该研究包括在7.1±4.5年的随访期间确定的1391例突发中风病例和随机队列样本中的1050名参与者。在162种代谢物中，13种候选代谢物与先前卒中的相互作用在ap值<0.05，其中一种代谢物乙酰谷氨酰胺超过了Bonferroni调整dp值阈值（相互作用p值= 5.78 × 10−5）。在纳入传统卒中危险因素的调整模型中，乙酰谷氨酰胺与卒中复发相关（HR = 2.27 / SD增量，95% CI = 1.60-3.20,p= 3.52 × 10−6），但与首次卒中无关（HR = 0.96 / SD增量，95% CI = 0.87-1.06,p= 0.44）。乙酰谷氨酰胺与复发性卒中相关，但与首次卒中无关，与传统卒中危险因素无关。未来的研究需要阐明乙酰谷氨酰胺的发病机制和卒中复发风险。
Approximately one-quarter of strokes occur in individuals with prior stroke. Despite the advancement in secondary stroke prevention, the long-term risk of recurrent stroke has remained unchanged. The objective of this study was to identify metabolite risk markers that are associated with recurrent stroke. We performed targeted metabolomic profiling of 162 metabolites by liquid chromatography-tandem mass spectrometry in baseline plasma in a stroke case-cohort study nested within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, an observational cohort study of 30,239 individuals aged 45 and older enrolled in 2003–2007. Weighted Cox proportional hazard models were used to identify metabolites that had a differential effect on first-time versus recurrent stroke using an interaction term between metabolite and prior stroke at baseline (yes or no). The study included 1391 incident stroke cases identified during 7.1 ± 4.5 years of follow-up and 1050 participants in the random cohort sample. Among 162 metabolites, 13 candidates had a metabolite-by-prior stroke interaction at ap-value <0.05, with one metabolite, acetylglutamine, surpassing the Bonferroni adjustedp-value threshold (pfor interaction = 5.78 × 10−5). In an adjusted model that included traditional stroke risk factors, acetylglutamine was associated with recurrent stroke (HR = 2.27 per SD increment, 95% CI = 1.60–3.20,p= 3.52 × 10−6) but not with first-time stroke (HR = 0.96 per SD increment, 95% CI = 0.87–1.06,p= 0.44). Acetylglutamine was associated with recurrent stroke but not first-time stroke, independent of traditional stroke risk factors. Future studies are warranted to elucidate the pathogenesis of acetylglutamine and recurrent stroke risk.