PMID- 35699588
OWN - NLM
STAT- MEDLINE
DCOM- 20221027
LR  - 20221027
IS  - 1899-5276 (Print)
IS  - 1899-5276 (Linking)
VI  - 31
IP  - 10
DP  - 2022 Oct
TI  - Citrulline and long-term mortality in patients with cardiovascular disease.
PG  - 1121-1128
LID - 10.17219/acem/150475 [doi]
AB  - BACKGROUND: Cardiovascular disease (CVD) is associated with intestinal barrier 
      dysfunction and increased intestinal permeability. Increased intestinal 
      permeability to gut microbial metabolites may accelerate the progression of CVD. 
      Plasma citrulline levels are a marker of functional enterocyte mass, and reduced 
      citrulline levels indicate intestinal epithelial damage. Citrulline was reported 
      as a useful prognostic marker in critically ill patients. However, data are 
      lacking on the association of citrulline with long-term mortality in patients 
      with CVD and with the levels of trimethylamine N-oxide (TMAO), a 
      microbiota-derived metabolite which has been implicated in the pathogenesis of 
      CVD. OBJECTIVES: To assess the effect of citrulline levels, a marker of 
      intestinal barrier disruption, on long-term mortality in patients with CVD. 
      Moreover, the relationship between the concentrations of 2 biomarkers - 
      citrulline and TMAO - was assessed. MATERIAL AND METHODS: Serum citrulline levels 
      were retrospectively assessed in 1036 consecutive patients with CVD (median age: 
      62 years; 61% men) hospitalized between 2013 and 2015. Associations of citrulline 
      levels with 5-year mortality rates as well as anthropometric and biochemical 
      parameters were evaluated for the entire study group and in subgroups of patients 
      with acute coronary syndrome (ACS), chronic coronary syndrome, chronic heart 
      failure (chronic HF), and atrial fibrillation (AF). Correlations between serum 
      citrulline and TMAO levels were assessed. RESULTS: The median citrulline level in 
      the study population was 22.5 muM (interquartile range (IQR): 17.8-27.9). 
      Citrulline levels were not associated with 5-year mortality in patients with CVD 
      (hazard ratio (HR) = 0.99; 95% confidence interval (95% CI): 0.97-1.00; p = 
      0.49). Median citrulline levels differed significantly between deceased patients 
      and survivors at 5 years in patients with ACS (p = 0.025). There were no 
      significant correlations between citrulline and TMAO levels (Kendall's tau = 
      0.027). CONCLUSIONS: Decreasing citrulline levels do not predict long-term 
      mortality of hospitalized patients with CVD. Moreover, they are not associated 
      with the serum levels of TMAO in these patients.
FAU - Konieczny, Radoslaw Andrzej
AU  - Konieczny RA
AD  - Jan Mikulicz-Radecki University Teaching Hospital, Clinic of Gastroenterology and 
      Hepatology, Wroclaw, Poland.
FAU - Zurawska-Plaksej, Ewa
AU  - Zurawska-Plaksej E
AD  - Department of Toxicology, Wroclaw Medical University, Poland.
FAU - Kaaz, Konrad
AU  - Kaaz K
AD  - Institute of Heart Diseases, Wroclaw Medical University, Poland.
FAU - Czapor-Irzabek, Hanna
AU  - Czapor-Irzabek H
AD  - Laboratory of Elemental Analysis and Structural Research, Wroclaw Medical 
      University, Poland.
FAU - Bombala, Wojciech
AU  - Bombala W
AD  - Statistical Analysis Centre, Wroclaw Medical University, Poland.
FAU - Mysiak, Andrzej
AU  - Mysiak A
AD  - Institute of Heart Diseases, Wroclaw Medical University, Poland.
FAU - Kuliczkowski, Wiktor
AU  - Kuliczkowski W
AD  - Institute of Heart Diseases, Wroclaw Medical University, Poland.
LA  - eng
PT  - Journal Article
PL  - Poland
TA  - Adv Clin Exp Med
JT  - Advances in clinical and experimental medicine : official organ Wroclaw Medical 
      University
JID - 101138582
RN  - FLD0K1SJ1A (trimethyloxamine)
RN  - 29VT07BGDA (Citrulline)
RN  - 0 (Biomarkers)
SB  - IM
MH  - Male
MH  - Humans
MH  - Middle Aged
MH  - Female
MH  - Citrulline
MH  - *Cardiovascular Diseases
MH  - Retrospective Studies
MH  - Prognosis
MH  - Biomarkers
MH  - *Acute Coronary Syndrome
OTO - NOTNLM
OT  - TMAO
OT  - cardiovascular diseases
OT  - citrulline
OT  - gut permeability
OT  - intestinal barrier
EDAT- 2022/06/15 06:00
MHDA- 2022/10/28 06:00
CRDT- 2022/06/14 09:52
PHST- 2022/06/15 06:00 [pubmed]
PHST- 2022/10/28 06:00 [medline]
PHST- 2022/06/14 09:52 [entrez]
AID - 10.17219/acem/150475 [doi]
PST - ppublish
SO  - Adv Clin Exp Med. 2022 Oct;31(10):1121-1128. doi: 10.17219/acem/150475.