肠源性代谢产物氧化三甲胺与心肾疾病的相关研究进展

Research advances in correlation between intestinal metabolite trimethylamine-N-oxide and heart and kidney disease

慢性肾脏病(chronic kidney disease,CKD)已经是威胁全球人类健康的重大疾病,其常并发严重的心血管事件,如高血压、动脉粥样硬化(atherosclerosis,AS)、冠心病(coronary artery heart disease,CHD)、心力衰竭(heart failure,HF)等。心血管疾病(cardiovascular disease,CVD)又可形成反向作用,诱导肾功能障碍,双方互为因果关系,是导致CKD患者死亡风险增加的主要原因。近年来有关肠道菌群与器官健康和疾病的关系成为国内外学者的研究热点。氧化三甲胺(trimethylamine-Noxide,TMAO)作为一类主要由肠道菌群代谢产生、具有生物活性的水溶性小分子化合物,通过引发一系列的病理生理改变,参与CKD与CVD的发生、发展。因此,为深入了解肠源性代谢产物TMAO对于治疗心肾疾病的临床意义,本文从TMAO如何参与CKD以及CVD病因机制方面阐述其重要价值。

At present,chronic kidney disease(CKD)has become a major disease threatening human health around the world,and it is often complicated with serious cardiovascular events,such as hypertension,atherosclerosis,coronary artery disease,heart failure and so on.However,cardiovascular diseases(CVD)can also have a feedback and induce renal dysfunction.There is a causal relationship between CKD and CVD,which is the main reason for the increased risk of death in patients with CKD.In recent years,the relationship between intestinal flora and organs in health and disease has become a hot spot for scholars at home and abroad.Trimethylamine-n-oxide(TMAO),as a class of biologically active and water-soluble small molecule compounds mainly produced by intestinal flora,is involved in the occurrence and development of CKD and CVD by triggering a series of pathophysiological changes.Therefore,in order to further understand the clinical significance of intestinal metabolite TMAO in the treatment of cardio-renal diseases,this review will elaborate the important value of TMAO from the aspect of how TMAO participates in CKD and the etiology and mechanism of CVD.