中国北方患者血浆三甲胺 N-氧化物水平与心力衰竭分类的相关性。

The correlation between plasma trimethylamine N-oxide level and heart failure classification in northern Chinese patients.

机构信息

Department of Pharmacy, the First Affiliated Hospital, Harbin Medical University, Harbin, China.

Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China.

出版信息

Ann Palliat Med. 2020 Sep;9(5):2862-2871. doi: 10.21037/apm-20-296. Epub 2020 Sep 7.

DOI:10.21037/apm-20-296

PMID:32921087

Abstract

BACKGROUND

Trimethylamine N-oxide (TMAO) has been identified as a new biomarker of cardiovascular disease. Our aim was to evaluate the plasma levels of TMAO in patients with or without heart failure (HF), and to indicate the correlation between plasma TMAO level and HF classification in northern Chinese patients.

METHODS

A total of 112 control participants and 184 HF patients participated in this study. Plasma levels of TMAO and N-terminal probrain natriuretic peptide (NT-proBNP) in all participants were examined and analyzed.

RESULTS

The plasma TMAO levels were remarkably higher in HF patients than that in control participants (7.0±0.6 vs. 1.5±0.1 μmol/L; P<0.01). In addition, the plasma TMAO levels of significantly increased from NYHA II to NYHA IV group (3.5±0.9, 6.0±0.8 and 8.1±1.0 μmol/L, respectively). The receiver operating characteristic analysis (ROC) showed that area under the curve (AUC) of TMAO was 0.881 (P<0.01). Furthermore, the AUC value for TMAO was 0.857 (95% CI: 0.674-1.000; P<0.01), 0.845 (95% CI: 0.778-0.911; P<0.01) and 0.914 (95% CI: 0.872-0.956; P<0.01) in NYHA II, NYHA III and NYHA IV groups, respectively. Univariate and multivariate logistic regression analysis indicated that TMAO was an independent risk factor for HF in patients. The level of TMAO was positively correlated with NT-proBNP. However, the diagnostic ability of TMAO was lower than that of NT-proBNP.

CONCLUSIONS

TMAO was an independent predictor of HF, moreover, the TMAO levels were highly associated with HF classification in northern Chinese patients.

摘要

背景

三甲基胺 N-氧化物（TMAO）已被确定为心血管疾病的一种新的生物标志物。我们的目的是评估中国北方心力衰竭（HF）患者和无心力衰竭患者的血浆 TMAO 水平，并指出 TMAO 水平与 HF 分类之间的相关性。

方法

本研究共纳入 112 名对照参与者和 184 名 HF 患者。所有参与者均检测并分析了血浆 TMAO 和 N 末端脑利钠肽前体（NT-proBNP）水平。

结果

HF 患者的血浆 TMAO 水平明显高于对照组（7.0±0.6 比 1.5±0.1 μmol/L；P<0.01）。此外，从 NYHA II 级到 NYHA IV 级，血浆 TMAO 水平显著升高（分别为 3.5±0.9、6.0±0.8 和 8.1±1.0 μmol/L）。受试者工作特征分析（ROC）显示 TMAO 的曲线下面积（AUC）为 0.881（P<0.01）。此外，TMAO 的 AUC 值在 NYHA II、NYHA III 和 NYHA IV 组中分别为 0.857（95%CI：0.674-1.000；P<0.01）、0.845（95%CI：0.778-0.911；P<0.01）和 0.914（95%CI：0.872-0.956；P<0.01）。单因素和多因素 logistic 回归分析表明，TMAO 是 HF 患者的独立危险因素。TMAO 水平与 NT-proBNP 呈正相关。然而，TMAO 的诊断能力低于 NT-proBNP。