苯乙酰谷氨酰胺与心房颤动的相关性研究

The correlation between phenylacetylglutamine and atrial fibrillation

目的探讨肠道菌群代谢产物苯乙酰谷氨酰胺(PAGln)与心房颤动(房颤)的关系。方法研究纳入2020年8月到2021年3月由武汉大学人民医院东院心内科收治的60例房颤患者为实验组,另选取同期住院的30例窦性心律患者为对照组。液相色谱-质谱法检测两组患者血清PAGln水平,分析两组患者临床资料、血液学指标和心脏重构指标的组间差异,采用多因素logistic回归分析房颤的独立相关因素,秩相关分析PAGln与炎症指标及心肌重构指标的相关性,采用受试者操作特征(ROC)曲线评估PAGln水平对房颤发生的预测价值。结果房颤组血清PAGln水平高于对照组[1.72(0.81~2.77)比0.69(0.36~1.32),P<0.001]。除PAGln外,吸烟、高血压、N末端B型利钠肽原(NT-proBNP)、白介素-6(IL-6)、转化生长因子β(TGF-β)、左心房内径(LAD)和左心室射血分数(LVEF)的组间差异有统计学意义(P均<0.05)。多因素logistic回归分析表明,吸烟、PAGln、IL-6、TGF-β和LAD与房颤独立相关(P均<0.05)。且PAGln水平与IL-6(r=0.266,P<0.05)、NT-proBNP(r=0.215,P<0.05)和LAD(r=0.366,P<0.001)正相关。血清PAGln的ROC曲线下方面积(AUC)为0.779(95%CI 0.686~0.873,P<0.001)。结论血清PAGln水平可能是房颤发生的相关因素,PAGln水平可能与心脏炎症反应和心脏重构呈正相关。

Objective To investigate the relationship between phenylacetylglutamine(PAGln),a metabolite of gut microbiota,and atrial fibrillation.Methods Sixty patients with atrial fibrillation admitted by the Department of Cardiology,East District of Renmin Hospital of Wuhan University from August 2020 to March 2021 were included in the study as the experimental group,and another 30 patients with sinus rhythm hospitalized during the same period were selected as the control group.Serum PAGln levels of the two groups of patients were measured by liquid chromatography mass spectrometry.The clinical data,hematological indexes and cardiac remodeling indexes of the two groups of patients were compared.Logistic regression was used to analyze the independently related factors of atrial fibrillation.Rank correlation analysis was used to determine the correlation between PAGln and the related factors of atrial fibrillation or myocardial remodeling index.The Receiver Operating Characteristic(ROC)curve was used to evaluate the predictive value of PAGln level for the occurrence of atrial fibrillation.Results Serum PAGln levels were higher in the atrial fibrillation group than in the control group[1.72(0.81-2.77)vs.0.69(0.36-1.32),P<0.001].In addition to PAGln,Smoking,Hypertension,N-terminal brain natriuretic peptide precursor(NT-proBNP),interleukin-6(IL-6),transforming growth factor-β(TGF-β),left atrial diameter(LAD)and left ventricular ejection fraction(LVEF)between the groups were statistically significant(all P<0.05).Multivariate logistic regression analysis showed that Smoking,PAGln,IL-6,TGFβand LAD were related factors for atrial fibrillation(all P<0.05).And PAGln levels were positively correlated with IL-6(r=0.266,P<0.05),NT-proBNP(r=0.215,P<0.05)and LAD(r=0.366,P<0.001).The area under curve(AUC)of serum PAGln was 0.779(95%CI 0.686-0.873,P<0.001).Conclusion Serum PAGln level may be a related factor of atrial fibrillation,and PAGln level may be positively correlated with cardiac inflammatory response and cardiac remodeling.