Serum tryptophan and kynurenine levels and risk of heart failure among patients with chronic kidney disease

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-02-07 DOI:10.1016/j.clnu.2025.01.028

Sara Mohiti , Jacob Christensen , Nino E. Landler , Ida MH. Sørensen , Jesper Qvist Thomassen , Sasha S. Bjergfelt , Ditte Hansen , Bo Feldt-Rasmussen , Susanne Bro , Mehrangiz Ebrahimi-Mameghani , Tor Biering-Sørensen , Line S. Bisgaard , Christina Christoffersen

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引用次数: 0

Abstract

Background and aims

Chronic kidney disease (CKD) is often complicated by heart failure (HF), leading to increased mortality. Emerging evidence suggests that Tryptophan metabolites, through the Kynurenine pathway (KP), play a significant role in HF pathophysiology. Therefore, we explored the association of Tryptophan (TRP), Kynurenine (KYN), and the Kynurenine to Tryptophan ratio (KTR) with HF in CKD, hypothesizing a link between KP alterations and HF occurrence in this population.

Methods

673 non-dialysis patients aged 30 to 75 with CKD stages 1–5 were included. Incident HF data were collected through medical record reviews, and the median follow-up time was 3.9 years. Serum concentrations of KYN and TRP were measured using High-Performance Liquid Chromatography (HPLC).

Results

Patients with more advanced stages of CKD had higher levels of KYN and KTR, and lower levels of TRP (p < 0.001). Following adjustments for age, sex, BMI, hypertension, and hypercholesterolemia, serum KYN and KTR remained significantly associated with prevalent HF in patients with CKD (p = 0.012, p = 0.028 respectively). Furthermore, Cox-regression analysis indicated that KTR concentration was associated with incident HF after adjusting for confounders such as age, sex, BMI, hypertension, hypercholesterolemia and diabetes (p = 0.019).

Conclusion

In conclusion, the present analysis suggests that changes in the kynurenine pathway may be a new biomarker for HF in patients with CKD. Thus, KTR concentration might be associated with prevalent and future HF in patients with CKD. Further research is needed to understand the mechanisms and potential of these metabolites in refining HF risk prediction and prevention in CKD patients.

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慢性肾病患者血清色氨酸和犬尿氨酸水平与心力衰竭风险的关系

背景和目的慢性肾脏疾病（CKD）常并发心力衰竭（HF），导致死亡率增加。越来越多的证据表明，色氨酸代谢物通过犬尿氨酸途径（KP）在心衰病理生理中发挥重要作用。因此，我们探讨了色氨酸（TRP）、犬尿氨酸（KYN）和犬尿氨酸与色氨酸的比值（KTR）与慢性肾病中HF的关系，假设KP改变与该人群中HF的发生之间存在联系。方法纳入673例30 ~ 75岁CKD 1 ~ 5期非透析患者。通过病历回顾收集事件HF数据，中位随访时间为3.9年。采用高效液相色谱法测定血清KYN和TRP浓度。结果CKD越晚期患者KYN、KTR水平越高，TRP水平越低(p <；0.001)。在调整了年龄、性别、BMI、高血压和高胆固醇血症后，血清KYN和KTR仍然与CKD患者的流行HF显著相关（p = 0.012, p = 0.028）。此外，cox -回归分析显示，在调整了年龄、性别、BMI、高血压、高胆固醇血症和糖尿病等混杂因素后，KTR浓度与HF发生率相关（p = 0.019）。结论犬尿氨酸通路的改变可能是CKD患者HF的一个新的生物标志物。因此，KTR浓度可能与CKD患者的流行和未来HF有关。需要进一步的研究来了解这些代谢物在改善CKD患者HF风险预测和预防方面的机制和潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.