Is Trimethylamine N-oxide (TMAO) Associated with NF-κB mRNA Expression in Patients with Coronary Artery Disease?

Abstract Background: Trimethylamine N-oxide (TMAO), a gut microbiota metabolite, is associated with cardiovascular disease (CVD) development. TMAO can trigger an inflammatory response by inducing the nuclear factor-kappa B (NF-κB) signaling cascade and increasing the expression of pro-inflammatory cytokines, contributing to the worsening of CVD. This study aimed to evaluate the association between TMAO plasma levels and inflammation in patients with coronary artery disease (CAD). Methods: A cross-sectional study was carried out including 29 patients with CAD. Peripheral blood mononuclear cells (PBMC) were isolated from fasting blood samples, and NF-κB and vascular cell adhesion protein 1 (VCAM1) mRNA expression were estimated using real-time quantitative PCR. We determined TMAO plasma levels by LC-MS/MS and TNF-α by ELISA. Routine biochemical parameters were evaluated using an automatic biochemical analyzer. Correlations were estimated by Spearman or Pearson test. Statistical significance was set at the level of p < 0.05. Results: All patients presented TMAO levels within the normal range according to EUTox (normal range: 2.83 ± 1.53 mg/L; CAD patients: 0.2 [0.1 to 0.2] ng/μL). TMAO plasma levels were positively correlated with NF-κB mRNA expression (0.555; p = 0.002). Conclusion: TMAO plasma levels may be associated with NF-κB mRNA expression in patients with CAD and may contribute to the pathogenesis of this disease.

Nutritional aspects of adult patients treated with chronic peritoneal dialysis / Aspectos nutricionais de pacientes adultos em diálise peritoneal

Patients treated with chronic peritoneal dialysis (PD) are often malnourished, as evidenced by low visceral protein levels, decreased anthropometricmeasurements and low scores of subjective global assessment. On the other hand, recent reports have shown that these patients tend to gain body weightand body fat in the first 2 years of PD and some of them may develop overweight/obesity. The simultaneous existence of overweight and obesity as wellas of protein-energy malnutrition (sarcopenia) is a particular nutritional pattern seen in PD. This review aims to describe the main aspects related to thenutritional status of PD patients, including the factors predisposing the development of malnutrition and overweight, the energy and protein requirementsfor these patients, the factors related to better survival and the tools that can be used to assess the nutritional status of PD patients.

Pacientes em diálise peritoneal (DP) apresentam uma série de marcadores nutricionais indicativos de desnutrição energético-protéica. Dentre essesmarcadores destacam-se as concentrações reduzidas de proteínas viscerais e valores baixos de medidas antropométricas e de avaliacão global subjetiva.Por outro lado, alguns estudos recentes tem mostrado que pacientes em DP apresentam uma tendência a ganhar peso e gordura corporal, principalmentenos primeiros 2 anos de DP. Esse resultado também vem chamado atencão, pois alguns pacientes chegam a desenvolver quadros desobrepeso/obesidade. A ocorrencia simultânea de desnutrição e sobrepeso/obesidade faz com que esses pacientes tenham um perfil nutricional bastanteparticular. Sendo assim, o objetivo desta revisão é o de abordar os aspectos nutricionais de pacientes em DP, tais como as possíveis causas de desnutriçãoenergético-protéica e de sobrepeso/obesidade, as necessidades energéticas e protéicas, os fatores relacionados com melhor sobrevida, além de descreveras formas de avaliar o estado nutricional assim como a periodicidade que estas devem ser feitas.