Huang Po-Yu, Lin Yu-Li, Chen Yi-Hsin, Hung Szu-Chun, Liou Hung-Hsiang, Tsai Jen-Pi, Hsu Bang-Gee
Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan.
Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan.
Toxins (Basel). 2024 Dec 3;16(12):523. doi: 10.3390/toxins16120523.
Trimethylamine -oxide (TMAO), a gut microbiome-derived metabolite, participates in the atherogenesis and vascular stiffening that is closely linked with cardiovascular (CV) complications and related deaths in individuals with kidney failure undergoing peritoneal dialysis (PD) therapy. In these patients, arterial stiffness (AS) is also an indicator of adverse CV outcomes. This study assessed the correlation between serum TMAO concentration quantified with high-performance liquid chromatography and mass spectrometry and central AS measured by carotid-femoral pulse wave velocity (cfPWV) in patients with chronic PD. Of the 160 participants included, 23.8% had a cfPWV of ≥10 m/s, which fulfilled the AS criteria. Multivariable logistic regression analysis revealed that TMAO, age, and waist circumference were positively associated with AS. Multivariable stepwise linear regression showed that underlying diabetes, advanced age, waist circumference, systolic blood pressure, and logarithmic-transformed TMAO were independently correlated with cfPWV. The area under the receiver operating characteristic curve for TMAO in differentiating AS from non-AS was 0.737. In conclusion, serum TMAO level was significantly independently correlated with central AS among participants undergoing PD for end-stage kidney failure.
氧化三甲胺（TMAO）是一种源自肠道微生物群的代谢产物，参与动脉粥样硬化的形成和血管硬化过程，而这与接受腹膜透析（PD）治疗的肾衰竭患者的心血管（CV）并发症及相关死亡密切相关。在这些患者中，动脉僵硬度（AS）也是不良心血管结局的一个指标。本研究评估了采用高效液相色谱和质谱法定量的血清TMAO浓度与通过颈股脉搏波速度（cfPWV）测量的中心动脉僵硬度之间的相关性，研究对象为慢性腹膜透析患者。在纳入的160名参与者中，23.8%的人cfPWV≥10 m/s，符合动脉僵硬度标准。多变量逻辑回归分析显示，TMAO、年龄和腰围与动脉僵硬度呈正相关。多变量逐步线性回归表明，潜在糖尿病、高龄、腰围、收缩压以及对数转换后的TMAO与cfPWV独立相关。TMAO区分动脉僵硬度与非动脉僵硬度的受试者工作特征曲线下面积为0.737。总之，在接受终末期肾衰竭腹膜透析的参与者中，血清TMAO水平与中心动脉僵硬度显著独立相关。
