Circulating Trimethylamine N-Oxide Is Associated with Increased Risk of Cardiovascular Mortality in Type-2 Diabetes: Results from a Dutch Diabetes Cohort (ZODIAC-59)
Autor: | Peter R van Dijk, Erwin Garcia, Gerjan Navis, Jose L. Flores-Guerrero, Stephan J. L. Bakker, Henk J. G. Bilo, Robin P. F. Dullaart, Margery A. Connelly |
---|---|
Přispěvatelé: | Value, Affordability and Sustainability (VALUE), Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT) |
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
030209 endocrinology & metabolism Trimethylamine N-oxide TMAO Type 2 diabetes 030204 cardiovascular system & hematology METABOLISM Gastroenterology trimethylamine-N-oxide Article DISEASE 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine cardiovascular disease Internal medicine Diabetes mellitus medicine EQUATION GUT BCAA type 2 Diabetes Proportional hazards model business.industry Hazard ratio General Medicine medicine.disease Confidence interval chemistry MARKER Cohort Medicine Biomarker (medicine) biomarker business |
Zdroj: | Journal of Clinical Medicine Volume 10 Issue 11 Journal of Clinical Medicine, 10(11):2269. MDPI AG Journal of Clinical Medicine, Vol 10, Iss 2269, p 2269 (2021) |
ISSN: | 2077-0383 |
DOI: | 10.3390/jcm10112269 |
Popis: | Trimethylamine N-oxide (TMAO), a novel cardiovascular (CV) disease and mortality risk marker, is a gut microbiota-derived metabolite as well. Recently, plasma concentrations of branched-chain amino acids (BCAA) have been reported to be affected by microbiota. The association of plasma TMAO with CV mortality in Type 2 Diabetes (T2D) and its determinants are still incompletely described. We evaluated the association between plasma BCAA and TMAO, and the association of TMAO with CV mortality in T2D individuals. We used data of 595 participants (mean age 69.5 years) from the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) cohort were analyzed. Plasma TMAO and BCAA were measured with nuclear magnetic resonance spectroscopy. CV mortality risk was estimated using multivariable-adjusted Cox regression models. Cross-sectionally, TMAO was independently associated with BCAA standardized (Std) β = 0.18 (95% Confidence Interval (CI) 0.09 0.27), p < 0.001. During a median follow-up of 10 years, 113 CV deaths were recorded. In Cox regression analyses, adjusted for multiple clinical and laboratory variables including BCAA, TMAO was independently associated with CV mortality: adjusted hazard ratio (adjHR) 1.93 (95% CI 1.11 3.34), p = 0.02 (for the highest vs. the lowest tertile of the TMAO distribution). The same was true for analyses with TMAO as continuous variable: adjHR 1.32 (95% CI 1.07 1.63), p = 0.01 (per 1 SD increase). In contrast, BCAAs were not associated with increased CV mortality. In conclusion, higher plasma TMAO but not BCAA concentrations are associated with an increased risk of CV mortality in individuals with T2D, independent of clinical and biochemical risk markers. |
Databáze: | OpenAIRE |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |