Correlation Between Trimethylamine N-Oxide Content And Severity Of Coronary Atherosclerotic Stenosis

Coronary atherosclerotic heart disease(CHD)is a kind of heart disease caused by coronary atherosclerosis,which leads to lumen stenosis or occlusion,myocardial ischemia,hypoxia or necrosis.CHD is a common disease that seriously endangers human health.Recent studies have shown that intestinal microorganisms and their metabolites may be related to CHD.Intestinal flora metabolizes the diet ingested by the host into a series of metabolites,such as trimethylamine N-oxide(TMAO)and so on.Some studies suggest that there may be a correlation between TMAO levels and cardiovascular disease risk.Objective: In this study,SYNTAX score was used to quantify the degree of coronary atherosclerotic stenosis,and high performance liquid chromatography-tandem mass spectrometry(HPLC-MS)was used to determine the level of TMAO in serum of CHD patients.The main purpose of this study was to investigate the relationship between TMAO and the degree of coronary atherosclerotic stenosis.Methods:1.From June 2018 to January 2019,107 patients underwent coronary angiography in the second Hospital of Hebei Medical University.Detailed records of the patient's clinical data,Including: age,sex,body mass index,urea,creatinine,uric acid,fasting blood glucose,fibrinogen,total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,B-type natriuretic peptide,left ventricular ejection fraction.2.According to the results of coronary angiography,SYNTAX score was performed.The score of 0-22 was defined as low score,the score of 23-32 was defined as middle score,and the score above 33 was defined as high score.3.The level of TMAO in serum was measured by HPLC-MS,and the correlation between the level of TMAO and the degree of coronary atherosclerotic stenosis was studied.Results:1.Baseline dataThere were no significant differences in age,sex,body mass index,urea,creatinine,uric acid,total cholesterol,triglyceride,low density lipoprotein cholesterol and high density lipoprotein cholesterol among the three groups with low,middle and high SYNTAX scores.There were significant differences in fasting blood glucose(P=0.00),fibrinogen(P=0.03),left ventricular ejection fraction(P=0.01)and B-type natriuretic peptide(P=0.01).2.Patient TMAO levelThe level of TMAO in SYNTAX low score group was significantly lower than that in high score group(P < 0.05),and the level of TMAO in middle score group was significantly lower than that in high score group(P < 0.05),but there was no significant difference in TMAO level between low score group and middle score group.3.Correlation between serum TMAO level and SYNTAX scoreSpearman analysis showed that there was a positive correlation between serum TMAO level and coronary artery SYNTAX score in CHD patients(r=0.25,P<0.05).Conclusions: Serum TMAO level was positively correlated with the severity of coronary artery.With the severity of CHD,SYNTAX score increased,serum TMAO level increased.When the CHD was mild,the change of TMAO was not obvious.The level of TMAO increased significantly in the presence of severe CHD,which indicated that the increase of TMAO level might indicate the degree of CHD.