血清胆汁酸亚组分TDCA与脑卒中高危人群发生心脑血管事件的关系

Association of serum taurousodeoxycholic acid(TDCA)level with cardio-cerebrovascular events in high risk population of stroke

目的探讨血清胆汁酸亚组分牛磺脱氧胆酸(TDCA)与脑卒中高危人群发生心脑血管事件的关系。方法采用高效液相色谱-串联质谱法检测脑卒中高危人群中27例发生心脑血管事件(观察组)和37例无心脑血管事件患者(对照组)血清中胆汁酸亚组分表达情况,根据脑卒中高危人群TDCA水平四分位数(P_(25)=0.010μmol/L,P_(50)=0.027μmol/L,P_(75)=0.053μmol/L)分成Q1组(0~<0.010μmol/L)、Q2组(0.010~<0.027μmol/L)、Q3组(0.027~<0.053μmol/L)和Q4组(≥0.053μmol/L)。采用logistic回归模型分析TDCA水平与发生心脑血管事件的关系,采用Spearman秩相关分析TDCA水平与临床和实验室指标的关系。结果观察组TDCA水平高于对照组(P<0.05);Q4组发生心脑血管事件的风险高于Q1组(P<0.05):模型1结果显示Q4组发生心脑血管事件的风险是Q1组的8.250倍,模型2显示Q4组发生心脑血管事件的风险是Q1组的7.671倍,模型3显示Q4组发生心脑血管事件的风险是Q1组的98.594倍。TDCA水平与血清同型半胱氨酸、胰岛素和γ谷氨酰转肽酶均有相关性(均P<0.05)。结论脑卒中高危人群中高水平TDCA患者与低水平患者比较发生心脑血管事件的风险更高。

Objective To investigate the association of serum taurousodeoxycholic acid(TDCA)level with cardiocerebrovascular events in high risk population of stroke.Methods The serum bile acid profiles in 64 subjects with high risk of stroke were detected by high performance liquid chromatography-tandem mass spectrometry(LC-MS/MS)determined,among whom 27 patients with cardio-cerebrovascular events occurred in 27 cases and did not occur in 37 cases.According to the quartile of serum TDCA level,patients were divided into 4 groups:Q1(0~<0.010μmol/L),Q2(0.010~<0.027μmol/L),Q3(0.027~<0.053μmol/L)and Q4(≥0.053μmol/L).The correlations of TDCA level with clinical and laboratory parameters were analyzed.Results The serum TDCA level in group with cardio-cerebrovascular events was higher than that in group without cardio-cerebrovascular events(P<0.05).Univariate and multivariate logistic regression analysis showed that the risk of cardiovascular and cerebrovascular events in Q4 was higher than that in Q1(P<0.05).Model 1 showed that the risk of cardiovascular and cerebrovascular events in TDCA Q4 was 8.250 times than that in Q1,model 2 showed 7.671 times than Q1,and model 3 showed 98.594 times than Q1.Serum TDCA level was correlated with HCY,INS and GGT levels(P<0.05).Conclusion Patients with high serum TDCA have higher risk of cardiovascular and cerebrovascular events than those with low concentration of TDCA.