Trimethylamine N-oxide predicts stroke severity in diabetic patients with acute ischaemic stroke and is related to glycemic variability

Li, Zaiwang1; Hui, Jiaojie2; Li, Suya3,4; Cao, Tingting3; Zhang, Jianping3; Mao, Xuqiang3; Wang, Feng3; Wang, Fengyun3; He, Ping3; You, Yiping3; Xi, Guangjun3

2022

10.1111/ene.15249

EUROPEAN JOURNAL OF NEUROLOGY   影响因子和分区

1351-5101

1468-1331

Background and purpose The present study analyzed the relationship between circulating trimethylamine N-oxide (TMAO) levels and stroke severity in diabetic patients with acute ischaemic stroke. A further aim was to investigate whether higher TMAO levels were associated with platelet aggregation and glycemic variability. Methods This was a cross-sectional analysis of 108 patients with type 2 diabetes mellitus (DM) undergoing acute ischaemic stroke and 60 healthy controls. Fasting plasma TMAO was measured using high-performance liquid chromatography with online electrospray ionization tandem mass spectrometry. Results Plasma TMAO levels of patients with acute ischaemic stroke were significantly higher than those of healthy controls. Amongst stroke patients, 50 were defined as undergoing mild stroke, and their plasma TMAO levels were lower compared to those with moderate to severe stroke. Platelet aggregation and mean amplitude of glycemic excursions were both correlated with plasma TMAO levels and these relationships remained significant in multiple linear regression analyses. Moreover, in streptozotocin-induced diabetic rats fed a diet enriched with choline to increase TMAO synthesis, platelet aggregation was significantly increased in the DM + choline and fluctuating DM (FDM) + choline groups compared to the control group. This increase was abolished in rats receiving oral antibiotics, which markedly reduced plasma TMAO levels. Importantly, compared with the DM + choline group, the FDM + choline group displayed significantly elevated TMAO levels and higher platelet aggregation. Conclusions Our results demonstrated that higher plasma TMAO levels were associated with stroke severity and suggested a novel link between plasma TMAO levels and glycemic variability in diabetic patients with acute ischaemic stroke.

acute ischaemic stroke diabetes mellitus glycemic variability platelet aggregation trimethylamine N-oxide

SCI

英语

第一

National Natural Science Foundation of China[81671219,82071364] ; Medical Young Talents Program of Jiangsu Province[QNRC2016191] ; Shenzhen Special Fund for Basic Research (Shenzhen Natural Science Foundation)[JCYJ20190806145812589] ; Top Talent Support Program for young and middle--aged people of Wuxi Health Committee[HB2020016]

Neurosciences & Neurology

Clinical Neurology ; Neurosciences

WOS:000744478300001

WILEY

NEUROSCIENCE & BEHAVIOR

Web of Science

1.Southern Univ Sci & Technol, Affiliated Hosp 1, Jinan Univ, Clin Med Coll 2,Dept Neurol,Shenzhen Peoples Hosp, Shenzhen, Peoples R China
2.Nanjing Med Univ, Affiliated Wuxi Peoples Hosp, Dept Crit Care Med, Wuxi, Jiangsu, Peoples R China
3.Nanjing Med Univ, Affiliated Wuxi Peoples Hosp, Dept Neurol, 299 Qingyang Rd, Wuxi 214023, Jiangsu, Peoples R China
4.Tongji Univ, Shanghai Peoples Hosp 4, Sch Med, Dept Neurol, Shanghai, Peoples R China

Li, Zaiwang,Hui, Jiaojie,Li, Suya,et al. Trimethylamine N-oxide predicts stroke severity in diabetic patients with acute ischaemic stroke and is related to glycemic variability[J]. EUROPEAN JOURNAL OF NEUROLOGY,2022.

Li, Zaiwang.,Hui, Jiaojie.,Li, Suya.,Cao, Tingting.,Zhang, Jianping.,...&Xi, Guangjun.(2022).Trimethylamine N-oxide predicts stroke severity in diabetic patients with acute ischaemic stroke and is related to glycemic variability.EUROPEAN JOURNAL OF NEUROLOGY.

Li, Zaiwang,et al."Trimethylamine N-oxide predicts stroke severity in diabetic patients with acute ischaemic stroke and is related to glycemic variability".EUROPEAN JOURNAL OF NEUROLOGY (2022).