Deidda Martino, Noto Antonio, Cadeddu Dessalvi Christian, Andreini Daniele, Andreotti Felicita, Ferrannini Eleuterio, Latini Roberto, Maggioni Aldo P, Magnoni Marco, Mercuro Giuseppe
Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy.
Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy.
Metabolites. 2022 Jan 27;12(2):123. doi: 10.3390/metabo12020123.
Traditional cardiovascular (CV) risk factors (RFs) and coronary artery disease (CAD) do not always show a direct correlation. We investigated the metabolic differences in a cohort of patients with a high CV risk profile who developed, or did not develop, among those enrolled in the Coronary Atherosclerosis in Outlier Subjects: Protective and Novel Individual Risk Factors Evaluation (CAPIRE) study. We studied 112 subjects with a high CV risk profile, subdividing them according to the presence (CAD/High-RFs) or absence of CAD (No-CAD/High-RFs), assessed by computed tomography angiography. The metabolic differences between the two groups were identified by gas chromatography-mass spectrometry. Characteristic patterns and specific metabolites emerged for each of the two phenotypic groups: high concentrations of pyruvic acid, pipecolic acid, p-cresol, 3-aminoisobutyric acid, isoleucine, glyceric acid, lactic acid, sucrose, phosphoric acid, trimethylamine-N-oxide, 3-hydroxy-3-methylglutaric acid, erythritol, 3-hydroxybutyric acid, glucose, leucine, and glutamic acid; and low concentrations of cholesterol, hypoxanthine, glycerol-3-P, and cysteine in the CAD/High-RFs group vs the No-CAD/High-RFs group. Our results show the existence of different metabolic profiles between patients who develop CAD and those who do not, despite comparable high CV risk profiles. A specific cluster of metabolites, rather than a single marker, appears to be able to identify novel predisposing or protective mechanisms towards CAD beyond classic CVRFs.
传统心血管（CV）危险因素（RFs）与冠状动脉疾病（CAD）并不总是呈现直接关联。我们在“异常受试者冠状动脉粥样硬化：保护性和新型个体危险因素评估（CAPIRE）研究”中，对一组具有高CV风险特征且发生或未发生CAD的患者队列中的代谢差异进行了调查。我们研究了112名具有高CV风险特征的受试者，根据计算机断层扫描血管造影评估的CAD存在情况（CAD/高RFs）或不存在情况（无CAD/高RFs）将他们进行细分。通过气相色谱 - 质谱法确定两组之间的代谢差异。两个表型组各自出现了特征模式和特定代谢物：CAD/高RFs组相对于无CAD/高RFs组，丙酮酸、哌啶酸、对甲酚、3 - 氨基异丁酸、异亮氨酸、甘油酸、乳酸、蔗糖、磷酸、氧化三甲胺、3 - 羟基 - 3 - 甲基戊二酸、赤藓糖醇、3 - 羟基丁酸、葡萄糖、亮氨酸和谷氨酸浓度较高；胆固醇、次黄嘌呤、甘油 - 3 - 磷酸和半胱氨酸浓度较低。我们的结果表明，尽管CV风险特征相当，但发生CAD的患者与未发生CAD的患者之间存在不同的代谢谱。一组特定的代谢物，而非单一标志物，似乎能够识别出超越经典CV危险因素的针对CAD的新的易感或保护机制。
