健康增龄人群血浆氧化三甲胺水平与年龄和性别的相关性研究

A study on the relationship between the level of plasma trimethylamine N-oxide and age and gender in the healthy aging population

目的探讨健康增龄过程中影响血浆氧化三甲胺水平的因素。方法对2020年12月—2021年1月在上海市宝山区社区医院进行体检的健康群体使用随机数进行抽样,共抽取87例,并签署知情同意书。研究样本年龄分布为30~96岁,平均(69.3±17.4)岁,其中男性39例,女性48例。使用社区电子病历采集健康增龄人群的临床数据,并使用CKD-EPI估算受试者的肾小球滤过率(eGFR)。采用超高效液相色谱—质谱技术对健康人群的血浆氧化三甲胺(trimethylamine N-oxide,TMAO)及其前体物三甲胺(trimethylamine,TMA)进行绝对定量。根据性别对健康增龄人群的临床指标、TMAO和TMA进行分组比较。分析与年龄和TMAO的相关因素,并使用偏相关分析探讨增龄过程中影响血浆TMAO含量的因素。结果肌酐、红细胞数、血红蛋白、血小板、尿酸、直接胆红素和总胆固醇具有性别差异(P<0.05)。血尿素氮、TMAO、单个核细胞数、总胆汁酸、肌酐与年龄呈显著正相关(P<0.05),红细胞、血红蛋白、血小板、葡萄糖、总蛋白、白蛋白、总胆固醇、谷丙转氨酶、钙、肾滤过率与年龄呈显著负相关(P<0.05)。年龄、单核细胞、肌酐、总胆汁酸、血尿素氮、胆碱与TMAO呈显著正相关,eGFR与TMAO呈显著负相关(P<0.05)。在校正TMA和eGFR对TMAO的影响后,血浆TMAO含量仍与年龄呈显著正相关(P<0.05)。结论血浆TMAO水平在人群健康增龄过程中显著上升。在校正其前体来源(TMA)和排泄(肾小球滤过率)后,TMAO仍呈现出与年龄的显著正相关,表明增龄是血浆TMAO水平增加的独立因素。

Objective To explore the factors affecting the level of plasma trimethylamine N-oxide(TMAO)during healthy aging.Methods Random number was used to sample healthy individuals who underwent physical examinations at Community Hospitals in Baoshan District from December 2020 to January 2021.A total of 87 subjects were selected and informed consent was signed.Their age distribution ranged from 30 to 96 years old,with an average age of(69.3±17.4)years,including 39 males and 48 females.Their clinical data were collected by means of community electronic medical records and their glomerular filtration rate(eGFR)was estimated according to CKD-EPI.Ultra-high performance liquid chromatography-mass spectrometry(UHPLC-MS)was used to detect absolute quantification of plasma TMAO and its precursor trimethylamine(TMA)of these subjects.The clinical data,TMAO and TMA were compared among groups based on gender.Factors associated with age and TMAO were analyzed.Partial correlation analysis was used to investigate the factors affecting plasma TMAO content during aging process.Results There were gender differences in creatinine,red blood cell count,hemoglobin,platelets,uric acid,direct bilirubin,and total cholesterol(P<0.05).Blood urea nitrogen,TMAO,monocyte count,total bile acid and creatinine were significantly positively correlated with age(P<0.05),while red blood cells,hemoglobin,platelets,glucose,total protein,albumin,total cholesterol,alanine aminotransferase,calcium,and kidney filtration rate were significantly negatively correlated with age(P<0.05).Age,monocytes,creatinine,total bile acid,blood urea nitrogen,choline were significantly positively correlated with TMAO,while eGFR was significantly negatively correlated with TMAO(P<0.05).After adjusting for the effects of TMA and eGFR on TMAO,plasma TMAO content was still significantly positively correlated with age(P<0.05).Conclusion Plasma TMAO levels increase significantly during the healthy aging process.Even after adjusting for its precursor sources(TMA)and elimination(eGFR),TMAO still exhibits a significant positive correlation with age,indicating that aging is an independent factor for the increase of plasma TMAO level.