氧化三甲胺（TMAO）作为心血管事件的生物标志物：系统评价和荟萃分析。

TMAO as a biomarker of cardiovascular events: a systematic review and meta-analysis.

机构信息

Department of Medicine and Surgery, University of Insubria, Varese, Como, Italy.

Internal Medicine Unit, Ospedale S.Valentino, Montebelluna, Treviso, Italy.

出版信息

Intern Emerg Med. 2021 Jan;16(1):201-207. doi: 10.1007/s11739-020-02470-5. Epub 2020 Aug 10.

DOI:10.1007/s11739-020-02470-5

PMID:32779113

Abstract

BACKGROUND

Unmasking the residual cardiovascular risk is a major research challenge in the attempt to reduce cardiovascular disease (CVD) morbidity and mortality. Mounting evidence suggests that a high circulating level of trimethylamine N-oxide is a new potential CVD risk factor. We performed a systematic review of the published studies to clarify the association between circulating high levels of TMAO and cardiovascular events.

METHODS

Studies evaluating the association between TMAO and CVD events were searched by electronic databases up to December 2018. Pooled results were expressed as risk ratio (RR) with 95% pertinent confidence interval (CI).

RESULTS

Three studies for a total of 923 patients at high/very high CVD risk were included in our analysis. Overall, a high TMAO level was associated with both major adverse cardiovascular events (RR = 2.05; 95% CI 1.61-2.61) and all-cause mortality (RR = 3.42; 95% CI 2.27-5.15).

CONCLUSIONS

Our findings support a role of high TMAO levels in predicting CVD events. High levels of TMAO may be a new CVD risk factor, potentially useful to better plan personalized CVD prevention strategies.

摘要

背景

揭示残余心血管风险是降低心血管疾病（CVD）发病率和死亡率的主要研究挑战。越来越多的证据表明，三甲基胺 N-氧化物（trimethylamine N-oxide，TMAO）的循环水平升高是一个新的潜在 CVD 风险因素。我们对已发表的研究进行了系统评价，以阐明 TMAO 与心血管事件之间的关系。

方法

通过电子数据库检索了截至 2018 年 12 月评估 TMAO 与 CVD 事件之间关系的研究。汇总结果表示为风险比（risk ratio，RR）及其 95%置信区间（confidence interval，CI）。

结果

我们的分析共纳入了三项研究，总计 923 例 CVD 高危/极高危患者。总体而言，TMAO 水平升高与主要不良心血管事件（major adverse cardiovascular events，MACE；RR=2.05；95%CI 1.61-2.61）和全因死亡率（all-cause mortality，ACM；RR=3.42；95%CI 2.27-5.15）均相关。