血浆氧化三甲胺水平与非瓣膜性心房颤动的相关性研究  

Correlation between plasma trimethylamine oxide level and nonvalvular atrial fibrillation

作　　者：张婷 汪盛平 曹文斋[3] Zhang Ting;Wang Shengping;Cao Wenzhai(Health Humanities Research Center,Sichuan Health and Rehabilitation Vocational College,Zigong643000,Sichuan Province,China)

机构地区：[1]四川卫生康复职业学院健康人文研究中心,自贡643000 [2]成都市青白江区人民医院心血管内科 [3]自贡市第一人民医院心血管内科

出　　处：《中华老年心脑血管病杂志》2023年第4期381-385,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：自贡市重点科技计划项目(2020YXY03,2015ZC02);四川大学自贡市2018年校地科技合作专项(2018CDZG-21)。

摘　　要：目的研究老年人血浆氧化三甲胺(TMAO)表达水平与非瓣膜性心房颤动(NVAF)发生风险的相关性,探索心房颤动早期诊断的生物标志物。方法选取2019年10月至2020年12月在自贡市第一人民医院心内科确诊的老年NVAF患者127例为NVAF组,选取同期住院的老年正常窦性心律患者85例为对照组。收集患者的临床资料,采用高效液相色谱串联质谱法测定血浆TMAO浓度。比较2组患者TMAO水平,应用Spearman相关性分析TMAO与NVAF其他指标的相关性,二元logistic回归分析TMAO与NVAF疾病发生风险,基于TMAO及其他危险因素构建诺莫(Nomogram)模型,采用ROC曲线评价Nomogram模型及TMAO的预测效能。结果NVAF组血浆TMAO水平明显高于对照组[3.27(1.73,5.06)μmol/L vs 2.05(1.50,2.62)μmol/L,P<0.01]。Spearman相关性分析显示,TMAO水平与NVAF患者血肌酐、胱抑素C、肌钙蛋白I呈正相关(r=0.389,r=0.260,r=0.255,P<0.01)。二元logistic回归分析显示,TMAO是NVAF疾病发生的危险因素(OR=1.662,95%CI:1.205~2.293,P<0.01)。校正年龄、性别等因素后,TMAO仍是NVAF疾病发生独立危险因素(OR=1.667,95%CI:1.207~2.302,P<0.01)。ROC曲线提示构建的Nomogram模型预测效能较好。血浆TMAO预测老年人发生NVAF的AUC为0.716(95%CI:0.650~0.775,P<0.01)。结论老年NVAF患者血浆TMAO水平明显增高,且与NVAF发生风险独立相关。Objective To investigate the correlation between the expression level of plasma trimethylamine oxide(TMAO)and the risk of nonvalvular atrial fibrillation(NVAF)in the elderly,and to explore biomarkers for the early diagnosis of atrial fibrillation.Methods A total of 127patients with NVAF diagnosed in the Department of Cardiology of Zigong First People's Hospital from October 2019to December 2020(AF group)and 85elderly patients with normal sinus rhythm hospitalized in the same period(control group)were recruited in this study.The clinical data of patients were collected,and the plasma TMAO concentration was determined by liquid chromatography tandem mass spectrometry(LC-MS/MS)and then compared between the two groups.Spearman correlation analysis was used to analyze the correlation of TMAO with other NVAF indicators,and binary logistic regression was adopted to analyze the risk of TMAO and NVAF disease.A nomogram model was constructed based on TMAO and other risk factors,and ROC curve was drawn to evaluate the predictive performances of the model and TMAO.Results The plasma TMAO level was significantly higher in the NVAF patients than the control group[3.27(1.73,5.06)μmol/L vs 2.05(1.50,2.62)μmol/L,P<0.01].Correlation analysis showed that TMAO level was positively correlated with serum creatinine,Cys-C and cTnI in the NVAF patients(r=0.389,0.260,0.255,P<0.01).Binary logistic regression analysis indicated that TMAO was risk factor of NVAF disease(OR=1.662,95%CI:1.205-2.293,P<0.01).After adjustment for age,sex and other factors,TMAO was still an independent risk factor for NVAF disease(OR=1.667,95%CI:1.207-2.302,P<0.01).ROC curve analysis suggested that the nomogram constructed had good prediction efficiency,and the AUC of plasma TMAO in predicting NVAF in the elderly was 0.716(95%CI:0.650-0.775,P<0.01).Conclusion Plasma TMAO level is significantly increased in elderly patients with NVAF,and is independently related to the risk of NVAF.

关 键 词：心房颤动 危险因素 数据相关性 氧化三甲胺 

分 类 号：R541.75[医药卫生—心血管疾病]