Wang Xinran, Peng Xinyue, Liu Jun, Tang Shiqi, Yang Xinyu, Wang Jianwen
Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China.
The Critical Kidney Disease Research Center of Central South University, Changsha, China.
Ren Fail. 2025 Dec;47(1):2481202. doi: 10.1080/0886022X.2025.2481202. Epub 2025 Mar 20.
This study aims to explore the relationship between trimethylamine N-oxide (TMAO), body composition, and protein-energy wasting (PEW) in patients undergoing maintenance hemodialysis (MHD).
A total of 127 MHD patients participated in this study. Body composition was measured using the InBody770 multi-frequency body composition analyzer. Plasma TMAO concentrations were assessed by ELISA. Cross-sectional analysis was performed after collecting demographic data, dialysis-related data, laboratory parameters, and body composition data from MHD patients.
In MHD patients, the PEW group exhibited lower levels of hemoglobin (Hb), albumin (ALB), transferrin (TF), creatinine (Cr), triglycerides (TG), prealbumin (PALB), soft lean mass (SLM), body mass index (BMI), percent of body fat (PBF), arm muscle circumference (AMC), and phase angle (PHA) compared to the non-PEW group, while C-reactive protein (CRP) and trimethylamine-N-oxide (TMAO) levels, as well as Extracellular Water/Total Body Water (ECW/TBW) ratio, were higher in the PEW group than in the non-PEW group. After full adjustment, TMAO and ECW/TBW ratio were independent risk factors for PEW in MHD patients. Further, plasma TMAO levels correlated negatively with Cr, ALB, Hb, BMI, and PHA, and positively with ECW/TBW in MHD patients with PEW. The ROC curve analysis indicated that the area under the curve (AUC) for plasma TMAO in predicting PEW in MHD patients was 0.788.
Plasma TMAO levels and certain body composition are associated with the occurrence of PEW in MHD patients. Plasma TMAO levels appear to serve as a potential predictive marker for the onset of PEW.
本研究旨在探讨维持性血液透析（MHD）患者中氧化三甲胺（TMAO）、身体成分与蛋白质能量消耗（PEW）之间的关系。
共有127例MHD患者参与本研究。使用InBody770多频身体成分分析仪测量身体成分。通过酶联免疫吸附测定法（ELISA）评估血浆TMAO浓度。收集MHD患者的人口统计学数据、透析相关数据、实验室参数和身体成分数据后进行横断面分析。
在MHD患者中，与非PEW组相比，PEW组的血红蛋白（Hb）、白蛋白（ALB）、转铁蛋白（TF）、肌酐（Cr）、甘油三酯（TG）、前白蛋白（PALB）、瘦软体重（SLM）、体重指数（BMI）、体脂百分比（PBF）、上臂肌肉周长（AMC）和相位角（PHA）水平较低，而PEW组的C反应蛋白（CRP）和氧化三甲胺（TMAO）水平以及细胞外水/总体水（ECW/TBW）比值高于非PEW组。经过全面调整后，TMAO和ECW/TBW比值是MHD患者发生PEW的独立危险因素。此外，在患有PEW的MHD患者中，血浆TMAO水平与Cr、ALB、Hb、BMI和PHA呈负相关，与ECW/TBW呈正相关。ROC曲线分析表明，血浆TMAO预测MHD患者发生PEW的曲线下面积（AUC）为0.788。
血浆TMAO水平和某些身体成分与MHD患者PEW的发生有关。血浆TMAO水平似乎可作为PEW发生的潜在预测标志物。
