Nakajima Takafumi, Fukuda Taira, Shibasaki Ikuko, Obi Syotaro, Sakuma Masashi, Abe Shichiro, Fukuda Hirotsugu, Toyoda Shigeru, Nakajima Toshiaki
Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.
Department of Liberal Arts and Sciences, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan.
Int J Cardiol Heart Vasc. 2024 Mar 14;51:101386. doi: 10.1016/j.ijcha.2024.101386. eCollection 2024 Apr.
L-carnitine exerts protective effects, such as maintaining mitochondrial functions and decreasing reactive oxygen species, while acylcarnitine (AC) is linked to the development of heart failure and atherosclerosis.
Serum carnitines play important pathophysiological roles in cardiovascular diseases.
Pre-operative biochemical data were obtained from 117 patients (71 men, average age 69.9 years) who underwent surgery for cardiovascular diseases. Measurements included pre-operative biochemical data including estimated glomerular filtration rate (eGFR), physical functions, skeletal muscle mass index (SMI) measured by bioelectrical impedance analysis, anterior thigh muscle thickness (MTh) measured by ultrasound, and routine echocardiography. Carnitine components were measured with the enzyme cycling method. Muscle wasting was diagnosed based on the Asian Working Group for Sarcopenia criteria.
Plasma brain natriuretic peptide (BNP) level was correlated with serum free carnitine (FC) and AC level, and the acylcarnitine/free carnitine ratio (AC/FC). AC/FC was elevated with stage of chronic kidney disease. In multivariate analysis, log (eGFR) and log (BNP) were extracted as independent factors to define log (serum AC) (eGFR: β = 0.258, p = 0.008; BNP: β = 0.273, p = 0.011), even if corrected for age, sex and body mass index. AC/FC was negatively correlated with hand-grip strength (r = -0.387, p = 0.006), SMI (r = -0.314, p = 0.012), and anterior thigh MTh (r = -0.340, p = 0.014) in men.
A significant association between serum AC level and AC/FC, and chronic kidney disease and heart failure exists in patients with cardiovascular diseases who have undergone cardiovascular surgery. Skeletal muscle loss and muscle wasting are also linked to the elevation of serum AC level and AC/FC.
左旋肉碱具有保护作用，如维持线粒体功能和减少活性氧，而酰基肉碱（AC）与心力衰竭和动脉粥样硬化的发展有关。
血清肉碱在心血管疾病中发挥重要的病理生理作用。
从117例接受心血管疾病手术的患者（71名男性，平均年龄69.9岁）中获取术前生化数据。测量包括术前生化数据，包括估计肾小球滤过率（eGFR）、身体功能、通过生物电阻抗分析测量的骨骼肌质量指数（SMI）、通过超声测量的大腿前侧肌肉厚度（MTh）以及常规超声心动图。采用酶循环法测量肉碱成分。根据亚洲肌少症工作组标准诊断肌肉减少症。
血浆脑钠肽（BNP）水平与血清游离肉碱（FC）、AC水平以及酰基肉碱/游离肉碱比值（AC/FC）相关。AC/FC随着慢性肾脏病分期升高。在多变量分析中，即使校正了年龄、性别和体重指数，log（eGFR）和log（BNP）仍被提取为定义log（血清AC）的独立因素（eGFR：β = 0.258，p = 0.008；BNP：β = 0.273，p = 0.011）。在男性中，AC/FC与握力（r = -0.387，p = 0.006）、SMI（r = -0.314，p = 0.012）和大腿前侧MTh（r = -0.340，p = 0.014）呈负相关。
在接受心血管手术的心血管疾病患者中，血清AC水平和AC/FC与慢性肾脏病和心力衰竭之间存在显著关联。骨骼肌丢失和肌肉减少症也与血清AC水平和AC/FC升高有关。
