Influence of gut microbiota-derived trimethylamine N-oxide on early neurological deterioration in diabetic patients with acute ischemic stroke
10.3760/cma.j.issn.0254-9026.2023.07.008
- VernacularTitle:肠道菌群代谢产物氧化三甲胺对糖尿病急性缺血性卒中早期神经功能恶化的影响
- Author:
Jiaojie HUI
1
;
Feng WANG
;
Xuqiang MAO
;
Jianping ZHANG
;
Suya LI
;
Tingting CAO
;
Yachen SHI
;
Guangjun XI
Author Information
1. 南京医科大学附属无锡人民医院重症医学科，无锡 214023
- Keywords:
Stroke;
Diabetes;
Trimethylamine N-oxide
- From:
Chinese Journal of Geriatrics
2023;42(7):794-798
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influence of trimethylamine N-oxide(TMAO)on the development of early neurological deterioration(END)in diabetic patients with acute ischemic stroke.Methods:In this cross-sectional study, 108 type 2 diabetes patients with acute ischemic stroke treated at the Department of Neurology in the Affiliated Wuxi People’s Hospital of Nanjing Medical University between October 2019 and November 2020 were consecutively recruited.END was defined as an increase in the National Institutes of Health Stroke Scale(NIHSS)≥ 2 points and exclusion of intracranial hemorrhage or bleeding transformation in cranial imaging evaluation within 5 days of initial deterioration of neurological dysfunction.The patients were divided into 2 groups, an END(n=36)group and a non-END group(n=72). Fasting plasma TMAO was measured using isotope dilution liquid chromatography coupled to tandem mass spectrometry.Results:Of the 108 patients, 36(33.3%)were diagnosed with END, and their plasma TMAO levels were significantly higher compared with patients without END( Z=-3.500, P<0.001). For prediction of END, the area under the ROC curve for plasma TMAO levels was 0.707(95% CI: 0.603-0.811, P<0.001). The frequencies of END in subjects grouped via tertiles of TMAO were 22.2%, 19.4% and 58.3%, respectively, with significant differences between the 3 groups( χ2=14.979, P=0.001). Univariate analysis showed that elevated TMAO( OR=1.160, 95% CI: 1.050-1.282, P=0.004)was associated with END.A multivariate logistic regression model further confirmed the association between TMAO and END( OR=1.145, 95% CI: 1.033-1.269, P=0.010). Conclusions:Increased plasma TMAO levels are associated with END in diabetic patients with acute ischemic stroke.
