临床外科杂志 ›› 2022, Vol. 30 ›› Issue (3): 252-256.doi: 10.3969/j.issn.1005-6483.2022.03.015

• 论著 • 上一篇    下一篇

创伤性颅脑损伤病人肠道菌群代谢产物TMAO、SCFAs与血清代谢标志物水平的相关性

  

  1. 511300 广州医科大学附属第四医院神经外科(李焕良、侯晓彬、魏雪银、胡智);广州市增城区荔城医院急诊科(单柳如)
  • 收稿日期:2021-06-17 接受日期:2021-06-17 出版日期:2022-03-20 发布日期:2022-03-20
  • 基金资助:
    广州市增城区科技计划项目(ZCKJ2019009)

Correlation between TMAO and SCFAs of intestinal flora metabolites and serum metabolic marker levels in patients with traumatic brain injury

  • Received:2021-06-17 Accepted:2021-06-17 Online:2022-03-20 Published:2022-03-20

摘要: 目的 探讨创伤性颅脑损伤(traumatic brain injury,TBI)病人肠道菌群代谢产物氧化三甲胺(trimethylamine N-oxide,TMAO)、短链脂肪酸(SCFAs)与血清代谢标志物水平的相关性。 方法 2018年9月~2020年12月收治的99例TBI病人,选取健康体检者33例作为对照组。采用高效液相色谱法、气相色谱法及全自动生化分析仪法分别检测肠道TMAO、SCFAs中丁酸水平以及血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、糖化血红蛋白(HbA1c)和空腹血糖水平。 结果 TBI病人肠道TMAO水平及血清TC、TG、LDL-C、HbA1c和空腹血糖水平高于对照组,且随病情加重逐渐升高( P <0.05);肠道丁酸和血清HDL-C水平低于对照组,且随病情加重逐渐降低( P <0.05)。Pearson相关分析显示,TMAO与HbA1c和TC呈正相关,与TG和LDL-C呈负相关;丁酸与TG和LDL-C呈正相关,与TC和空腹血糖呈负相关。多因素Logistic回归分析显示,TC、LDL-C、HbA1c和空腹血糖水平是肠道TMAO和丁酸水平影响TBI病人预后的危险因素。 结论 肠道TMAO和丁酸水平与血清代谢标志物水平关系紧密,且与TBI病人病情进展相关,为防治TBI的提供可能的新靶点,但其机制需进一步研究。

关键词: 创伤性颅脑损伤, 肠道菌群代谢产物, 氧化三甲胺, 短链脂肪酸, 血清代谢标志物, 相关性

Abstract: Objective To investigate the relationship between trimethylamine N-oxide(TMAO),short-chain fatty acids(SCFAs) and serum of intestinal flora metabolites in patients with traumatic brain injury(TBI) Correlation of metabolic marker levels. Methods Among 99 TBI patients admitted from September 2018 to December 2020,33 healthy subjects were selected as the control group.Detect intestinal TMAO,SCFAs levels,serum total cholesterol(TC),triglyceride(TG),and high-density lipoprotein cholesterol by high-performance liquid chromatography,gas chromatography,and automatic biochemical analyzer.(High-density lipoprotein cholesterol,HDL-C),low-density lipoprotein cholesterol(LDL-C),glycosylated hemoglobin(HbA1c) and fasting blood glucose levels. Results The intestinal TMAO levels,serum TC,TG,LDL-C,HbA1c,and fasting blood glucose levels in TBI patients were higher than those in the control group,and gradually increased with the severity of the disease(P< 0.05) ;intestinal butyric acid and serum HDL-C levels were lower than the control group,and gradually decreased with the worsening of the disease( P <0.05).Pearson correlation analysis showed that TMAO was positively correlated with HbA1c and TC,and negatively correlated with TG and LDL-C.Butyric acid was positively correlated with TG and LDL-C,and was negatively correlated with TC and fasting blood glucose.Multivariate logistic regression analysis showed that TC,LDL-C,HbA1c and fasting blood glucose levels were the risk factors for the intestinal TMAO and butyric acid levels to affect the prognosis of TBI patients. Conclusion Intestinal TMAO and butyric acid levels are closely related to serum metabolic marker levels,and are related to the progression of TBI patients.They provide possible new targets for the prevention and treatment of TBI,but their mechanisms need to be further studied.

Key words: traumatic brain injury, intestinal flora metabolites, trimethylamine oxide, short-chain fatty acids, serum metabolic markers, correlation

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