Ribeiro Marcia, Kemp Julie Ann, Cardozo Ludmila, Vargas Drielly, Ribeiro-Alves Marcelo, Stenvinkel Peter, Mafra Denise
Graduate Program in Biological Sciences-Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-630, Brazil.
Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói 24220-900, Brazil.
Toxins (Basel). 2024 Dec 31;17(1):15. doi: 10.3390/toxins17010015.
In patients with chronic kidney disease (CKD), trimethylamine n-oxide (TMAO) accumulation exacerbates inflammation and contributes to oxidative stress. These complications are putatively linked to the development of cardiovascular diseases. Despite the known associations, the variation in TMAO plasma levels across different CKD stages and dialysis modalities remains underexplored. This study aimed to quantify TMAO plasma levels in different CKD stages and dialysis treatments.
This cross-sectional study assessed TMAO plasma levels in non-dialysis CKD patients (ND), patients undergoing hemodialysis (HD), and peritoneal dialysis (PD). TMAO plasma levels were assessed by liquid chromatography coupled to triple mass spectrometry quadrupole.
In total, 15 ND patients [stages 3-5, glomerular filtration rate 41.4 mL/min/1.73 m, 64 (IQR = 12.5) years, BMI 25.2 kg/m, eight women]; 14 PD patients [57.5 (IQR = 8.5) years, BMI of 27.8 kg/m, nine women]; and 34 HD patients [43.5 (IQR = 45.5) years, BMI of 24.4 kg/m, nineteen women] were analyzed. ND patients had lower TMAO levels when compared to the HD ( < 0.0001) and PD patients ( = 0.001). There was no difference in TMAO levels between patients undergoing dialysis ( < 0.59). There was a negative correlation between TMAO and HDL plasma levels [rho = -0.380 ( < 0.004)], calcium [rho = -0.321 ( < 0.016)], and albumin [rho = -0.416 ( < 0.001)]. In addition, a positive correlation between TMAO and urea levels was observed [rho = 0.717 ( < 0.001)].
CKD stages impact TMAO levels since patients on non-dialysis treatment had lower levels than patients on HD and PD.
在慢性肾脏病（CKD）患者中，氧化三甲胺（TMAO）蓄积会加剧炎症并导致氧化应激。这些并发症被认为与心血管疾病的发生有关。尽管存在已知的关联，但不同CKD阶段和透析方式下TMAO血浆水平的差异仍未得到充分研究。本研究旨在量化不同CKD阶段和透析治疗中TMAO的血浆水平。
这项横断面研究评估了非透析CKD患者（ND）、接受血液透析（HD）和腹膜透析（PD）患者的TMAO血浆水平。通过液相色谱-三重四极杆质谱联用技术评估TMAO血浆水平。
共分析了15例ND患者[3-5期，肾小球滤过率41.4 mL/min/1.73 m²，64（四分位间距=12.5）岁，体重指数25.2 kg/m²，8名女性]；14例PD患者[57.5（四分位间距=8.5）岁，体重指数27.8 kg/m²，9名女性]；以及34例HD患者[43.5（四分位间距=45.5）岁，体重指数24.4 kg/m²，19名女性]。与HD患者（P<0.0001）和PD患者（P=0.001）相比，ND患者的TMAO水平较低。透析患者之间的TMAO水平无差异（P>0.59）。TMAO与高密度脂蛋白血浆水平[r=-0.380（P<0.004）]、钙[r=-0.321（P<0.016）]和白蛋白[r=-0.416（P<0.001）]之间呈负相关。此外，观察到TMAO与尿素水平呈正相关[r=0.717（P<0.001）]。
CKD阶段会影响TMAO水平，因为非透析治疗患者的TMAO水平低于HD和PD患者。
