ABSTRACT
Objective:
To investigate the
association between trimethylamine-N-
oxide (TMAO) and the degree of
coronary atherosclerosis in
coronary heart diseases (CHD)
patients with
type 2 diabetes mellitus.
Methods:
Consecutive
patients,
who underwent
coronary angiography due to suspected CHD in
Beijing Hospital from November 2016 to January 2018, were screened in this
cross-sectional study. According to
blood glucose level,
previous medical history and
coronary angiography results, they were divided into CHD without type2
diabetes mellitus(CHD-nDM) group and CHD with type2
diabetes mellitus(CHD-DM) group.
Plasma TMAO levels in each group were measured by
LC-MS/MS. Spearman correlation
analysis was used to evaluate the correlation between TMAO and the number of diseased vessels and Gensini scores. Multivariate
logistic regression was used to analyze the correlation between TMAO and high Gensini scores.
Results:
A total of 590
patients were enrolled in the study, including 238
patients in CHD-DM group and 352
patients in CHD-nDM group.
Patients were older,
body mass index,
blood pressure level,
prevalence of
history of
hypertension and
statins use were higher in CHD-DM group than in CHD-nDM group (all P<0.05). The proportion of
patients with multivessel
disease (2 or more vessels) was also higher in CHD-DM group than in CHD-nDM group (P<0.001). Gensini score was higher in CHD-DM group than in CHD-nDM group (P<0.05).
Fasting blood glucose,
glycosylated hemoglobin and
urea were significantly higher, while
low-density lipoprotein cholesterol and
hemoglobin were significantly lower in CHD-DM group than in CHD-nDM group (all P<0.05). The levels of TMAO was significantly higher in CHD-DM group than in CHD-nDM group (P<0.001). Spearman correlation
analysis showed that TMAO was positively correlated with the number of diseased vessels, Gensini score, age and
blood glucose level (r=0.178, 0.189, 0.260, 0.111, respectively, all P<0.01). Multivariate
logistic regression analysis showed that, TMAO level was still positively correlated with high Gensini score in CHD-DM group (OR=2.25, 95%CI 1.16-4.38, P=0.017), but not in CHD-nDM group (OR=1.29, 95%CI 0.72-2.31, P=0.386) after adjusting for age,
sex,
body mass index,
low-density lipoprotein cholesterol,
high-density lipoprotein cholesterol, total
cholesterol,
triglyceride,
history of
hypertension,
hyperlipidemia,
smoking and
statin use.
Conclusions:
In CHD
patients with tupe 2
diabetes mellitus, the
plasma TMAO level is significantly increased and is independent and positively correlated with the degree of
coronary artery disease.