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Fasting Plasma Trimethylamine-N-Oxide as a Risk Marker of Poor Renal Outcomes, Cardiovascular Disease, and Mortality in Patients with Type 1 Diabetes with Diabetic Nephropathy

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  1. ASN Kidney Week 2017

    Aktivitet: Deltagelse i eller arrangering af en begivenhedOrganisation af og deltagelse i konference

  1. Essential Branched-Chain Amino Acids and Ribonic Acid Are Associated with Cardiorenal Events in Type 1 Diabetes

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  2. Genome-Wide Association Study of Diabetic Kidney Disease Highlights Biology Involved in Glomerular Basement Membrane Collagen

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Assessment of the Sublingual Microcirculation with the GlycoCheck System: Reproducibility and Examination Conditions

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  4. Hypoxia in individuals with type 1 diabetes and macroalbuminuria is associated with autonomic dysfunction

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  1. Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Essential Branched-Chain Amino Acids and Ribonic Acid Are Associated with Cardiorenal Events in Type 1 Diabetes

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Vis graf over relationer
Background Trimethylamine-N-Oxide (TMAO) is a metabolite of phosphatidylcholine, choline and carnitine produced by the gut microbiota from ingested animal foods. It has been suggested as an independent gut microbiota derived risk factor for renal and cardiovascular disease (CVD). Patients with type 1 diabetes are at increased risk of renal and cardiovascular disease and early mortality. We investigated associations between plasma TMAO and outcomes in a prospective study. Methods TMAO was measured at baseline in 384 patients with type 1 diabetes with diabetic nephropathy (u-AER > 300 mg/g), 61 % were male, mean age was 42 years and eGFR 66 ml/min/1.73m2. Fasting plasma levels of TMAO were measured using stable isotope dilution tandem mass-spectrometry. Endpoints included mean yearly decline in 51Cr EDTA GFR (follow-up (FU) up to 12 years), ESRD (n=65; mean FU: 7.2 years), fatal and non-fatal CVD (n=154; mean FU: 7.5 years) and all-cause mortality (n=134; mean FU: 9.0 years). Associations between TMAO and the endpoints were tested using linear regression or Cox proportional hazard regression in uni- and multivariate analyses adjusting for conventional risk factors at baseline. Results Plasma TMAO was inversely associated with baseline eGFR (R2: 0.42; p<0.001). In univariate analysis higher TMAO was associated with all endpoints (p≤0.002). All endpoints remained significant associated with higher TMAO after adjustment for baseline age, diabetes duration, sex, smoking, systolic blood pressure, cholesterol, HbA1c and u-AER (p ≤ 0.014). After further adjustment for baseline eGFR significance was lost for all endpoints, except for CVD events (HR per doubling: 1.22, [1.05-1.41]; p=0.010). Conclusion In type 1 diabetes patients with diabetic nephropathy, higher fasting plasma TMAO level was predictive of poor renal outcomes, CVD events and mortality independent of conventional risk factors. Only the relation to CVD events remained after further adjustment for baseline eGFR. This elucidated the close relationship between TMAO and renal function.
OriginalsprogEngelsk
ArtikelnummerSA-OR113
TidsskriftJournal of the American Society of Nephrology
Vol/bind28
Sider (fra-til)102-103
ISSN1046-6673
StatusUdgivet - 4 nov. 2017
BegivenhedASN Kidney Week 2017 - Ernest N. Morial Convention Center, New Orleans, USA
Varighed: 31 okt. 20175 nov. 2017
https://www.asn-online.org/kidneyweek/

Konference

KonferenceASN Kidney Week 2017
LokationErnest N. Morial Convention Center
LandUSA
ByNew Orleans
Periode31/10/201705/11/2017
Internetadresse

Begivenhed

ASN Kidney Week 2017

31/10/201705/11/2017

New Orleans, USA

Begivenhed: Konference

ID: 58494595