Lent-Schochet Daniella, Silva Ryan, McLaughlin Matthew, Huet Beverley, Jialal Ishwarlal
California North-state University, College of Medicine, Elk Grove, CA, USA.
University of Texas, Southwestern Medical Center, Dallas, TX, USA.
Horm Mol Biol Clin Investig. 2018 Apr 18;35(2):/j/hmbci.2018.35.issue-2/hmbci-2018-0015/hmbci-2018-0015.xml. doi: 10.1515/hmbci-2018-0015.
Background Metabolic syndrome (MetS), a cardio-metabolic cluster afflicting 35% of American adults, increases cardiovascular disease (CVD) and type-2 diabetes (T2DM) risk. Increased levels of trimethylamine N-oxide (TMAO), a metabolite derived from choline and L-carnitine, correlates with CVD and T2DM. However, the precise role of TMAO and its precursors in MetS remains unclear. We tested the hypothesis that choline, L-carnitine and TMAO in MetS patients without CVD or T2DM would be altered and correlate with inflammatory markers. Materials and methods This was an exploratory study of 30 patients with nascent MetS (without CVD or T2DM) and 20 matched controls. MetS was defined by the Adult Treatment Panel III criteria. TMAO and its precursors were evaluated from each patient's frozen early morning urine samples and quantified using liquid chromatography/mass spectrometry (LC-MS). These amines were correlated with a detailed repertoire of biomarkers of inflammation and adipokines. Results L-carnitine was significantly increased (p = 0.0002) compared to controls. There was a trend for a significant increase in TMAO levels (p = 0.08). Choline was not significantly altered in MetS. L-carnitine correlated significantly with soluble tumor necrosis factor 1 (sTNFR1) and leptin, and inversely to adiponectin. TMAO correlated with IL-6, endotoxin and chemerin. Neither choline, nor L-carnitine significantly correlated with TMAO. Conclusion L-carnitine is directly correlated with markers of inflammation in nascent MetS. Cellular L-carnitine could be a biomediator or marker of inflammation in the pathogenesis of MetS, and the sequelae of CVD and T2DM.
代谢综合征（MetS）是一种影响35%美国成年人的心血管代谢综合征群，会增加心血管疾病（CVD）和2型糖尿病（T2DM）的风险。三甲胺N-氧化物（TMAO）水平升高，一种由胆碱和左旋肉碱衍生的代谢物，与CVD和T2DM相关。然而，TMAO及其前体在MetS中的确切作用仍不清楚。我们测试了这样一个假设，即在没有CVD或T2DM的MetS患者中，胆碱、左旋肉碱和TMAO会发生改变，并与炎症标志物相关。
这是一项对30例初发MetS患者（无CVD或T2DM）和20例匹配对照的探索性研究。MetS由成人治疗小组III标准定义。从每位患者的冷冻晨尿样本中评估TMAO及其前体，并使用液相色谱/质谱（LC-MS）进行定量。这些胺类与炎症和脂肪因子的生物标志物详细清单相关。
与对照组相比，左旋肉碱显著增加（p = 0.0002）。TMAO水平有显著增加的趋势（p = 0.08）。MetS中胆碱没有显著改变。左旋肉碱与可溶性肿瘤坏死因子1（sTNFR1）和瘦素显著相关，与脂联素呈负相关。TMAO与IL-6、内毒素和chemerin相关。胆碱和左旋肉碱与TMAO均无显著相关性。
左旋肉碱与初发MetS中的炎症标志物直接相关。细胞左旋肉碱可能是MetS发病机制以及CVD和T2DM后遗症中炎症的生物介质或标志物。
