Serum Trimethylamine N-Oxide Level Is Positively Associated with Aortic Stiffness Measured by Carotid–Femoral Pulse Wave Velocity in Patients Undergoing Maintenance Hemodialysis

Abstract

Trimethylamine N-oxide (TMAO) is a biomarker that is effective in predicting major adverse cardiovascular (CV) events. Age-related vascular problems are significantly affected by aortic stiffness (AS), which is independently linked to CV morbidity and mortality. This study aimed to determine the association between serum TMAO levels and carotid–femoral pulse wave velocity (cfPWV) in patients receiving hemodialysis (HD) therapy. In total, 115 patients with HD were enrolled in this study. The AS group included patients whose cfPWV was >10 m/s. Using high-performance liquid chromatography and mass spectrometry, the levels of serum TMAO were measured. The AS group included 42 (36.5%) patients, and compared with the non-AS group, the rates of diabetes, hypertension, older age, systolic blood pressure, serum glucose, and TMAO levels were high. In the multivariate logistic regression analysis, serum TMAO and age were independently linked with AS after correcting for the factors significantly associated with AS. Following multivariate stepwise linear regression analysis, serum TMAO in these individuals was found to be strongly correlated with cfPWV values (p < 0.001). In patients on chronic HD, serum TMAO level is an independent measure of AS and strongly correlated with cfPWV.

Serum Phenylacetylglutamine among Potential Risk Factors for Arterial Stiffness Measuring by Carotid–Femoral Pulse Wave Velocity in Patients with Kidney Transplantation

“…This damage, in turn, can cause intestinal barrier destruction and microbial dysbiosis, which exacerbate systemic inflammation and create a harmful cycle of renal and cardiovascular injuries [ 26 ]. Other colonic microbial metabolites, including p-cresyl sulfate, indoxyl sulfate, and trimethylamine-N-oxide, have been linked to AS in CKD and hemodialysis patients, according to our earlier research [ 27 , 28 , 29 ]. Notably, uremic retention solutes, p-cresyl sulfate and indoxyl sulfate, are produced by colonic microbial metabolism.…”

“…SBP and diastolic blood pressure were measured at rest for 30 min, three times at 5 min intervals, and the results were analyzed. For the assessment of cfPWV values, pressure application tonometry was used, as previously described [ 27 , 28 , 29 ], utilizing the SphygmoCor system; AtCor Medical, Australia. After a minimum of 10 min of rest in a temperature-controlled, quiet room, the participant was placed in the supine position for these measurements.…”

Serum Endocan Is a Risk Factor for Aortic Stiffness in Patients Undergoing Maintenance Hemodialysis

“…The adequacy of HD was determined by urea clearance (Kt/V), using the single pool urea kinetic modeling. The serum levels of endocan (Aviscera Bioscience, Inc., Santa Clara, CA, USA) and intact parathyroid hormone (iPTH) (Abcam, Cambridge, MA, USA) were measured using commercially available enzyme-linked immunosorbent assay kits [ 12 , 13 ].…”

“…After asking the participant to relax in a supine position for at least 10 min, the cfPWV was measured using transcutaneous SphygmoCor probe (SphygmoCor system, AtCor Medical, Sydney, Australia), which simultaneously recorded the pulse waveform in the target artery area and electrocardiogram (ECG) [ 12 , 13 ]. After obtaining an accurate and reproducible pulse waveform, we recorded at least 12 s of signal or 10 consecutive cardiac cycles.…”

“…Many clinical studies focused on the correlation between the severity of aortic stiffness in patients with ESRD and various serum biomarkers, such as uremic toxin and inflammatory/atherosclerosis markers [ 12 , 13 ]. In the event of vascular inflammation, adipocytes produce both proinflammatory molecules, such as tumor necrosis factor alpha (TNFα), and anti-inflammatory molecules, such as adiponectin, to interfere with the function of monocytes/macrophages and the production of endocan, which was previously known as endothelial cell-specific molecule-1 (ESM1) [ 14 , 15 , 16 ].…”