The Dynamics of Carnitine, γ-butyrobetaine and Trimethylamine N-oxide in Diabetics and the Effects of Changes in Renal Function

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Vascular disorders progress alongside loss of renal function (cardio renal correlation), possibly due to higher blood concentrations of angiopathic substances. Gamma-butyrobetaine (γBB) is an angiopathic substance  produced by gut microbiota that feed on the carnitine present in dietary red meat. It is implicated in arteriosclerosis and long-term cardiovascular death. Trimethylamine N-oxide (TMAO), its hepatic metabolite, is also linked to vascular disorders. Our hypothesis is that urinary γBB excretion declines with decreasing renal function, causing a rise in its blood concentration and leading to the aggravation of vascular disorders. The dynamics of these substances in diabetes and the effects of changes in renal function have not yet been studied in detail. We investigated the dynamics of carnitine, γBB, and TMAO in the blood and urine of patients with diabetic kidney disease (DKD) and studied their relationships with renal function (eGFR) and intimamedia thickness (IMT).

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