25
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Assessment of trimethylamine N-oxide (TMAO) as a potential biomarker of severe stress in patients vulnerable to posttraumatic stress disorder (PTSD) after acute myocardial infarction Translated title: Evaluación del N-óxido de trimetilamina (TMAO) como posible biomarcador de estrés severo en pacientes vulnerables al trastorno de estrés postraumático (TEPT) después de un infarto agudo de miocardio Translated title: 对氧化三甲胺 (TMAO) 作为急性心肌梗死后创伤后应激障碍 (PTSD) 易感患者的严重应激潜在生物标志物的评估

      research-article

      a , b , c , a , d , e , e , e , f , a , a , b

      European Journal of Psychotraumatology

      Taylor & Francis

      Trimethylamine N-oxide (TMAO), acute myocardial infarction, gut permeability, posttraumatic stress disorder (PTSD), depression, biomarker, N-óxido de trimetilamina (TMAO), Infarto agudo del miocardio, Permeabilidad intestinal, Trastorno de estrés postraumático (TEPT), Depresión, Biomarcador, 氧化三甲胺 (TMAO), 急性心肌梗塞, 肠胃渗透性, 创伤后应激障碍 (PTSD), 抑郁, 生物标志物

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          ABSTRACT

          Background: Posttraumatic stress disorder (PTSD) is a frequently observed stress-related disorder after acute myocardial infarction (AMI) and it is characterized by numerous symptoms, such as flashbacks, intrusions and anxiety, as well as uncontrollable thoughts and feelings related to the trauma. Biological correlates of severe stress might contribute to identifying PTSD-vulnerable patients at an early stage.

          Objective: Aims of the study were (1) to determine whether blood levels of trimethylamine N-oxide (TMAO) vary immediately after AMI in patients with/without AMI-induced PTSD symptomatology, (2) to investigate whether TMAO is a potential biomarker that might be useful in the prediction of PTSD and the PTSD symptom subclusters re-experiencing, avoidance and hyperarousal, and (3) to investigate whether TMAO varies immediately after AMI in patients with/without depression 6 months after AMI.

          Method: A total of 114 AMI patients were assessed with the Hamilton-Depression Scale after admission to the hospital and 6 months later. The Clinician Administered PTSD Scale for DSM-5 was used to explore PTSD-symptoms at the time of AMI and 6 months after AMI. To assess patients’ TMAO status, serum samples were collected at hospitalization and 6 months after AMI.

          Results: Participants with PTSD-symptomatology had significantly higher TMAO levels immediately after AMI than patients without PTSD-symptoms (ANCOVA: TMAO(PTSD x time), F = 4.544, df = 1, p = 0.035). With the inclusion of additional clinical predictors in a hierarchical logistic regression model, TMAO became a significant predictor of PTSD-symptomatology. No significant differences in TMAO levels immediately after AMI were detected between individuals with/without depression 6 months after AMI.

          Conclusions: An elevated TMAO level immediately after AMI might reflect severe stress in PTSD-vulnerable patients, which might also lead to a short-term increase in gut permeability to trimethylamine, the precursor of TMAO. Thus, an elevated TMAO level might be a biological correlate for severe stress that is associated with vulnerability to PTSD.

          HIGHLIGHTS

          • An elevated TMAO level might be a biological correlate for severe stress that is associated with vulnerability to PTSD.

          Translated abstract

          Antecedentes: El trastorno de estrés postraumático (TEPT) es un trastorno relacionado con el estrés que se observa con frecuencia después de un infarto agudo de miocardio (IAM) y se caracteriza por numerosos síntomas, como flashbacks, intrusiones y ansiedad, así como pensamientos y sentimientos incontrolables relacionados con el trauma. Los correlatos biológicos del estrés severo podrían contribuir a identificar a los pacientes vulnerables al TEPT en una etapa temprana.

          Objetivo: Los objetivos del estudio fueron (1) determinar si los niveles sanguíneos de N-óxido de trimetilamina (TMAO, por sus siglas en ingles) varían inmediatamente después del IAM en pacientes con o sin sintomatología de TEPT inducida por IAM, (2) investigar si el TMAO es un biomarcador potencial que podría ser útil en la predicción de TEPT y los subgrupos de síntomas de TEPT que experimentan, evitación e hiperactivación, y (3) para investigar si el TMAO varía inmediatamente después del IAM en pacientes con o sin depresión 6 meses después del IAM.

          Método: Un total de 114 pacientes con IAM fueron evaluados con la Escala de Depresión de Hamilton tras su ingreso al hospital y 6 meses después. La Escala de TEPT para el DSM-5 administrada por el médico se utilizó para explorar los síntomas de TEPT en el momento del IAM y 6 meses después del IAM. Para evaluar el estado de TMAO de los pacientes, se recolectaron muestras de suero en la hospitalización y 6 meses después del IAM.

          Resultados: Los participantes con sintomatología de TEPT tenían niveles de TMAO significativamente más altos inmediatamente después del IAM que los pacientes sin síntomas de TEPT (ANCOVA: TMAO (TEPT x tiempo), F = 4.544, df = 1, p = 0.035). Con la inclusión de predictores clínicos adicionales en un modelo de regresión logística jerárquica, TMAO se convirtió en un predictor significativo de la sintomatología del TEPT. No se detectaron diferencias significativas en los niveles de TMAO inmediatamente después del IAM entre individuos con o sin depresión 6 meses después del IAM.

          Conclusiones: Un nivel elevado de TMAO inmediatamente después del IAM podría reflejar un estrés severo en pacientes vulnerables al TEPT, lo que también podría conducir a un aumento a corto plazo de la permeabilidad intestinal a la trimetilamina, el precursor de TMAO. Por lo tanto, un nivel elevado de TMAO podría ser un correlato biológico del estrés severo asociado con la vulnerabilidad al TEPT.

          Translated abstract

          背景: 创伤后应激障碍 (PTSD) 是急性心肌梗塞 (AMI) 后常被观测的应激相关疾病, 其特点是出现例如闪回, 闯入和焦虑, 以及无法控制的创伤相关想法和感觉的多种症状。 严重应激的生物学相关因素可能有助于在早期识别PTSD易感患者。

          目的: 本研究旨在 (1) 确定有/无AMI诱发PTSD症状的患者在AMI后氧化三甲胺 (TMAO) 的血液水平是否立即不同, (2) 考查TMAO是否是一种可能有助于预测PTSD和PTSD再体验, 回避和高唤起症状亚簇的潜在生物标志物, 并且 (3) 考查AMI后6个月有无抑郁的患者在AMI后TMAO是否立即不同。

          方法: 在入院后及6个月后共使用汉密尔顿抑郁量表评估了114例AMI患者。使用 DSM-5的临床用PTSD量表探究AMI期间及AMI后6个月的PTSD症状。为评估患者的TMAO状态, 在住院时和AMI后6个月收集了血清样本。

          结果: 有PTSD症状的参与者在AMI后的TMAO水平立即显著高于无PTSD症状患者的 (ANCOVA:TMAO (PTSD x时间), F= 4.544, df = 1, p= 0.035) 。在分层逻辑回归模型中纳入其他临床预测因素后, TMAO成为PTSD症状的一个显著预测因素。在AMI后6个月有或无抑郁的个体之间未发现AMI后即刻TMAO水平的显著差异。

          结论: AMI后立即升高的TMAO水平可能反映了PTSD易感患者的严重应激, 这也可能导致肠道对TMAO前体三甲胺的通透性的短期提升。因此, 升高的TMAO水平可能是与PTSD易感性相关的严重应激的生物学相关因素。

          Related collections

          Most cited references 46

          • Record: found
          • Abstract: not found
          • Book: not found

          Diagnostic and Statistical Manual of Mental Disorders

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            A new equation to estimate glomerular filtration rate.

            Equations to estimate glomerular filtration rate (GFR) are routinely used to assess kidney function. Current equations have limited precision and systematically underestimate measured GFR at higher values. To develop a new estimating equation for GFR: the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Cross-sectional analysis with separate pooled data sets for equation development and validation and a representative sample of the U.S. population for prevalence estimates. Research studies and clinical populations ("studies") with measured GFR and NHANES (National Health and Nutrition Examination Survey), 1999 to 2006. 8254 participants in 10 studies (equation development data set) and 3896 participants in 16 studies (validation data set). Prevalence estimates were based on 16,032 participants in NHANES. GFR, measured as the clearance of exogenous filtration markers (iothalamate in the development data set; iothalamate and other markers in the validation data set), and linear regression to estimate the logarithm of measured GFR from standardized creatinine levels, sex, race, and age. In the validation data set, the CKD-EPI equation performed better than the Modification of Diet in Renal Disease Study equation, especially at higher GFR (P < 0.001 for all subsequent comparisons), with less bias (median difference between measured and estimated GFR, 2.5 vs. 5.5 mL/min per 1.73 m(2)), improved precision (interquartile range [IQR] of the differences, 16.6 vs. 18.3 mL/min per 1.73 m(2)), and greater accuracy (percentage of estimated GFR within 30% of measured GFR, 84.1% vs. 80.6%). In NHANES, the median estimated GFR was 94.5 mL/min per 1.73 m(2) (IQR, 79.7 to 108.1) vs. 85.0 (IQR, 72.9 to 98.5) mL/min per 1.73 m(2), and the prevalence of chronic kidney disease was 11.5% (95% CI, 10.6% to 12.4%) versus 13.1% (CI, 12.1% to 14.0%). The sample contained a limited number of elderly people and racial and ethnic minorities with measured GFR. The CKD-EPI creatinine equation is more accurate than the Modification of Diet in Renal Disease Study equation and could replace it for routine clinical use. National Institute of Diabetes and Digestive and Kidney Diseases.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.

              Little is known about lifetime prevalence or age of onset of DSM-IV disorders. To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication. Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview. Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older. Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders. Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups. About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.
                Bookmark

                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8198
                2000-8066
                31 May 2021
                2021
                : 12
                : 1
                Affiliations
                [a ]Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz; , Graz, Austria
                [b ]Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz; , Graz, Austria
                [c ]Division of Cardiology, Department of Internal Medicine, Medical University of Graz; , Graz, Austria
                [d ]Department of Psychiatry and Psychotherapy I, State Hospital Graz II; , Graz, Austria
                [e ]ZARG Zentrum Für Ambulante Rehabilitation GmbH; , Graz, Austria
                [f ]Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz; , Graz, Austria
                Author notes
                CONTACT Dirk von Lewinski dirk.von-lewinski@ 123456medunigraz.at Division of Cardiology, Department of Internal Medicine, Medical University of Graz; , Auenbruggerplatz 15, 8036 Graz, Austria
                Article
                1920201
                10.1080/20008198.2021.1920201
                8168738
                5243adee-2a54-4a82-b0ca-a76f0e5f7b56
                © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 2, Tables: 4, References: 47, Pages: 1
                Product
                Categories
                Research Article
                Clinical Research Article

                Comments

                Comment on this article