We performed a case-control study nested in a community-based cohort (2013-2018, n = 16457). The study included 321 incident cases of IS and 321 controls matched by age and gender. Carnitine, lysine, trimethyllysine (TML), glycine, and their ratios were measured/calculated in the baseline plasma samples using ultra-high performance liquid chromatography-tandem mass-spectrometry (UHPLC-MS/MS). Conditional logistic regression analyses were used to calculate odds ratios (ORs) and their 95% confidence intervals (CIs).
Plasma carnitine, lysine, TML, and glycine were not significantly associated with the IS risk, although a gradually reduced risk was observed across the increasing tertiles of glycine. Notably, the ratios of glycine/carnitine, glycine/lysine, and glycine/TML were all inversely associated with the IS risk. Compared to the lowest tertiles, the corresponding odds ratios for the highest tertiles were 0.60 (95% CI: 0.40-0.91), 0.63 (95% CI: 0.42-0.94), and 0.63 (95% CI: 0.42-0.95), respectively, after adjustment for body mass index, smoking, hypertension, family history of stroke, estimated glomerular filtration rate and total cholesterol. Repeating the analyses by excluding the first two years of follow-up did not materially alter the risk associations for the ratios of glycine/lysine and glycine/carnitine.
Increased ratios of plasma glycine to carnitine, lysine, and TML were associated with a lower risk of incident IS. Our observational findings suggest that the homeostasis of circulating carnitine, lysine, TML, and glycine may involve in the pathogenesis of IS.
我们在社区队列中进行了一项病例对照研究(2013-2018年,n=16457)。该研究包括321例IS事件病例和321例年龄和性别相匹配的对照。肉碱,赖氨酸,三甲基赖氨酸(TML),甘氨酸,使用超高效液相色谱-串联质谱(UHPLC-MS/MS)在基线血浆样品中测量/计算它们的比率。使用条件逻辑回归分析来计算比值比(OR)及其95%置信区间(CI)。
血浆肉碱,赖氨酸,TML,和甘氨酸与IS风险没有显着相关,尽管在甘氨酸增加的三分位数中观察到风险逐渐降低。值得注意的是,甘氨酸/肉碱的比例,甘氨酸/赖氨酸,甘氨酸/TML均与IS风险呈负相关。与最低的三分位数相比,最高三分位数的相应比值比为0.60(95%CI:0.40-0.91),0.63(95%CI:0.42-0.94),和0.63(95%CI:0.42-0.95),分别,调整体重指数后,吸烟,高血压,中风家族史,估计肾小球滤过率和总胆固醇。通过排除前两年的随访重复分析并没有实质性改变甘氨酸/赖氨酸和甘氨酸/肉碱比率的风险关联。
血浆甘氨酸与肉碱的比例增加,赖氨酸,和TML与较低的IS事件风险相关.我们的观察结果表明,循环肉碱的稳态,赖氨酸,TML,甘氨酸可能参与了IS的发病机制。