吃肉或增加冠心病风险
创作:梁婷 审核:兵兵 2020年03月07日
  • 研究纳入760名健康女性,测定基线和10年后血浆氧化三甲胺(TMAO)水平发现,TMAO水平的增加与冠心病(CHD)风险升高显著相关;
  • 与TMAO水平相对恒定的人群相比,在基线和10年后两次测定中,TMAO水平最高的(前三分之一位数)人群,其患CHD的相对危险度(RR)为1.79;
  • 进一步发现,不健康的饮食可以加剧ΔTMAO-CHD相关性,而健康饮食可以缓解该相关性;
  • TMAO水平的长期升高可能预示CHD风险,且膳食可以调节TMAO和CHD的相关程度。
主编推荐语
兵兵
长期摄入动物性食品或带来血浆TMAO的升高。该研究对760名健康女性进行10年的追踪发现,若其TMAO水平持续升高,其患冠心病的风险也显著变大。但是,两者的这种相关性可以通过膳食改变。且TMAO经由肠道菌群代谢,本文也间接证实肠道菌群在此过程中发挥的作用。健康饮食被呼吁和推荐。
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Long-Term Changes in Gut Microbial Metabolite Trimethylamine N-Oxide and Coronary Heart Disease Risk

肠道代谢产物氧化三甲胺的长期变化与冠心病患病的风险

10.1016/j.jacc.2019.11.060

2020-02-17, Article

Abstract & Authors:展开

Abstract:收起
Background: A gut-microbial metabolite, trimethylamine N-oxide (TMAO), has been associated with coronary atherosclerotic burden. No previous prospective study has addressed associations of long-term changes in TMAO with coronary heart disease (CHD) incidence.
Objectives: The purpose of this study was to investigate whether 10-year changes in plasma TMAO levels were significantly associated with CHD incidence.
Methods: This prospective nested case-control study included 760 healthy women at baseline. Plasma TMAO levels were measured both at the first (1989 to 1990) and the second (2000 to 2002) blood collections; 10-year changes (Δ) in TMAO were calculated. Incident cases of CHD (n = 380) were identified after the second blood collection through 2016 and were matched to controls (n = 380).
Results: Regardless of the initial TMAO levels, 10-year increases in TMAO from the first to second blood collection were significantly associated with an increased risk of CHD (relative risk [RR] in the top tertile: 1.58 [95% confidence interval (CI): 1.05 to 2.38]; RR per 1-SD increment: 1.33 [95% CI: 1.06 to 1.67]). Participants with elevated TMAO levels (the top tertile) at both time points showed the highest RR of 1.79 (95% CI: 1.08 to 2.96) for CHD as compared with those with consistently low TMAO levels. Further, we found that the ΔTMAO-CHD relationship was strengthened by unhealthy dietary patterns (assessed by the Alternate Healthy Eating Index) and was attenuated by healthy dietary patterns (p interaction = 0.008).
Conclusions: Long-term increases in TMAO were associated with higher CHD risk, and repeated assessment of TMAO over 10 years improved the identification of people with a higher risk of CHD. Diet may modify the associations of ΔTMAO with CHD risk.

First Authors:
Yoriko Heianza

Correspondence Authors:
Lu Qi

All Authors:
Yoriko Heianza,Wenjie Ma,Joseph A DiDonato,Qi Sun,Eric B Rimm,Frank B Hu,Kathryn M Rexrode,JoAnn E Manson,Lu Qi

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