Clin Chem Lab Med. 2013 Nov;51(11):2187-93. doi: 10.1515/cclm-2013-0103.
The aminothiols homocysteine and, to a lesser extent, cysteine have been associated with adverse cardiovascular outcome, whereas glutathione, as an antioxidant, may protect against atherosclerosis and thrombosis. Potentially, the combined assessment of these aminothiols may provide a more accurate association with future cardiovascular outcome. We evaluated the association between recurrent atherothrombotic events and the concentration of total plasma cysteine, homocysteine, and glutathione and their combination.
Respective aminothiols were measured by high-performance liquid chromatography in blood plasma of consecutive first-day survivors admitted for an acute coronary syndrome between April 2002 and January 2004. The combined score was calculated using the combination of the individual aminothiols. The end point was the composite of cardiovascular death, myocardial infarction, and/or stroke.
A cohort of 375 consecutive patients (median age 66 years, 66% male) were followed for a median duration of 2.7 years. The end point occurred in 82 patients (22%). In univariate analyses, all aminothiols were significantly associated with the composite end point. After correction for possible confounders, only cysteine and glutathione remained significantly associated. The strongest association with the end point was observed for the combined score (adjusted hazard ratio, 1.40 per standard deviation increase; p=0.005).
Although homocysteine is generally considered the aminothiol of interest with respect to cardiovascular disease, in our prospective study, only cysteine and glutathione appeared independently associated with recurrent atherothrombotic events. Moreover, we showed that an imbalance in the combination of aminothiols could be of more importance than investigating the individual metabolites.
氨基硫醇同型半胱氨酸（homocysteine）和半胱氨酸（cysteine）与不良心血管结局相关，而谷胱甘肽（glutathione）作为一种抗氧化剂，可能对动脉粥样硬化和血栓形成有保护作用。这些氨基硫醇的综合评估可能与未来的心血管结局有更准确的关联。我们评估了复发性动脉粥样硬化血栓事件与总血浆半胱氨酸、同型半胱氨酸和谷胱甘肽浓度及其组合之间的关系。
在 2002 年 4 月至 2004 年 1 月期间，连续收治的因急性冠脉综合征入院的第一天幸存者的血液血浆中通过高效液相色谱法测量相应的氨基硫醇。使用个体氨基硫醇的组合计算组合评分。终点是心血管死亡、心肌梗死和/或中风的复合终点。
连续 375 例患者（中位数年龄 66 岁，66%为男性）入组，中位随访时间为 2.7 年。82 例患者（22%）发生终点事件。在单变量分析中，所有氨基硫醇均与复合终点显著相关。在纠正可能的混杂因素后，只有半胱氨酸和谷胱甘肽仍然与终点显著相关。与终点最相关的是联合评分（调整后的危险比，每标准差增加 1.40；p=0.005）。
虽然同型半胱氨酸通常被认为是与心血管疾病相关的氨基硫醇，但在我们的前瞻性研究中，只有半胱氨酸和谷胱甘肽与复发性动脉粥样硬化血栓事件独立相关。此外，我们表明，氨基硫醇组合的失衡可能比研究单个代谢物更为重要。
