Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Life Sci. 2023 Sep 15;329:121947. doi: 10.1016/j.lfs.2023.121947. Epub 2023 Jul 16.
Cardiovascular disease (CVD) remains the most common cause of death worldwide and has become a public health concern. The proven notable risk factors for CVD are atherosclerosis, hypertension, diabetes, dyslipidemia, inflammation, and some genetic defects. However, research has shown a correlation between metabolic health, gut microbiota, and dietary risk factors. The gut microbiota makes an important contribution to human functional metabolic pathways by contributing enzymes that are not encoded by the human genome, for instance, the breakdown of polysaccharides, polyphenols and vitamins synthesis. TMAO and SCFAs, human gut microbiota compounds, have respective immunomodulatory and pro-inflammatory effects. Choline and l-carnitine are abundant in high-fat diets and are transformed into TMA by gut bacteria. The liver's phase of metabolism then changes TMA into TMAO. In turn, TMAO promotes the activation of macrophages, damages vascular endothelium, and results in CVD-however, dysbiosis decreases SCFAs and bile acids, which raises intestinal permeability. Congestion in the portal vein, a drop in cardiac output, a reduction in intestinal perfusion, and intestinal leakage are all caused by heart failure. These factors induce systemic inflammation by increasing intestinal leakage. By raising CRP and pro-inflammatory reactions, human gut dysbiosis and elevated TMAO levels promote the development of arterial plaque, hasten the beginning of atherosclerosis, and raise the risk of CAD. A healthy symbiosis between the gut microbiota and host is a key factor in shaping the biochemical profile of the diet, therefore which are crucial for maintaining the intestinal epithelial barrier, growing mucosa, reducing inflammation, and controlling blood pressure.
心血管疾病（CVD）仍然是全球最常见的死亡原因，已成为公共卫生关注的焦点。已证实的 CVD 显著危险因素包括动脉粥样硬化、高血压、糖尿病、血脂异常、炎症和一些遗传缺陷。然而，研究表明代谢健康、肠道微生物群和饮食风险因素之间存在相关性。肠道微生物群通过贡献人类基因组未编码的酶，为人类功能性代谢途径做出重要贡献，例如多糖、多酚和维生素的分解。TMAO 和 SCFAs 是人类肠道微生物群的化合物，分别具有免疫调节和促炎作用。胆碱和左旋肉碱在高脂肪饮食中含量丰富，被肠道细菌转化为 TMA。然后，肝脏的代谢阶段将 TMA 转化为 TMAO。反过来，TMAO 促进巨噬细胞的激活，损害血管内皮，导致 CVD-然而，肠道菌群失调会降低 SCFAs 和胆汁酸，从而增加肠道通透性。门静脉充血、心输出量下降、肠道灌注减少和肠漏都是心力衰竭引起的。这些因素通过增加肠道渗漏引起全身炎症。通过提高 CRP 和促炎反应，人类肠道菌群失调和 TMAO 水平升高会促进动脉斑块的发展，加速动脉粥样硬化的发生，并增加 CAD 的风险。肠道微生物群和宿主之间的健康共生是塑造饮食生化特征的关键因素，因此对于维持肠道上皮屏障、生长黏膜、减少炎症和控制血压至关重要。
