Fasting but not changes of plasma metabolome during oral glucose tolerance tests improves the diagnosis of severe coronary arterial stenosis

Chi Sheng Hung, Hung Yuan Li, Ching Hua Kuo, Mao Shin Lin, Tien Chueh Kuo, Sung Jeng Tsai, Pi Hua Liu, Cheng Hsin Lin, Chun Yi Yang, Lee Ming Chuang, Ming Fong Chen, Yufeng J. Tseng, Hsien Li Kao

Research output: Contribution to journalArticle

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Abstract

Background Noninvasive stress tests for the diagnosis of significant coronary arterial stenosis requiring intervention are not perfect. We investigated whether plasma metabolome during the oral glucose tolerance test (OGTT) can improve the diagnosis. Methods A total of 117 subjects with positive stress test results who received coronary angiography were recruited. After excluding subjects with a history of myocardial infarction and subjects who did not receive OGTT, the 18 subjects without significant stenosis were selected as controls. Another 18 age- and sex-matched subjects with significant stenosis were selected as cases. Plasma metabolome from samples obtained in fasting, 30 and 120 min after OGTT was measured using liquid chromatography combined with time-of-flight mass spectrometry. Results We found five metabolites which can identify patients with significant stenosis independent to clinical risk factors, including diabetes, hypertension, hypercholesterolaemia, smoking and history of percutaneous coronary intervention (all P <0·05). The area under the receiver operating characteristic (AUROC) curve of these metabolites was 0·799-0·818 at fasting and 30 min after OGTT. The addition of metabolites to clinical factors increases the AUROC (0·616, 95%CI 0·429-0·803 for model with clinical factors only; 0·824, 95%CI 0·689-0·959 for model with four metabolites and clinical factors). The changes of plasma metabolite levels during OGTT did not significantly improve the diagnostic performance. Conclusions Fasting plasma metabolome, but not change of plasma metabolome during OGTT, can improve the diagnosis of significant stenosis in patients with positive noninvasive stress test results.

Original languageEnglish
Pages (from-to)483-489
Number of pages7
JournalClinical Endocrinology
Volume83
Issue number4
DOIs
Publication statusPublished - Oct 1 2015
Externally publishedYes

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Metabolome
Coronary Stenosis
Glucose Tolerance Test
Fasting
Pathologic Constriction
Exercise Test
ROC Curve
Percutaneous Coronary Intervention
Hypercholesterolemia
Coronary Angiography
Liquid Chromatography
Mass Spectrometry
Smoking
Myocardial Infarction
Hypertension

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Fasting but not changes of plasma metabolome during oral glucose tolerance tests improves the diagnosis of severe coronary arterial stenosis. / Hung, Chi Sheng; Li, Hung Yuan; Kuo, Ching Hua; Lin, Mao Shin; Kuo, Tien Chueh; Tsai, Sung Jeng; Liu, Pi Hua; Lin, Cheng Hsin; Yang, Chun Yi; Chuang, Lee Ming; Chen, Ming Fong; Tseng, Yufeng J.; Kao, Hsien Li.

In: Clinical Endocrinology, Vol. 83, No. 4, 01.10.2015, p. 483-489.

Research output: Contribution to journalArticle

Hung, CS, Li, HY, Kuo, CH, Lin, MS, Kuo, TC, Tsai, SJ, Liu, PH, Lin, CH, Yang, CY, Chuang, LM, Chen, MF, Tseng, YJ & Kao, HL 2015, 'Fasting but not changes of plasma metabolome during oral glucose tolerance tests improves the diagnosis of severe coronary arterial stenosis', Clinical Endocrinology, vol. 83, no. 4, pp. 483-489. https://doi.org/10.1111/cen.12713
Hung, Chi Sheng ; Li, Hung Yuan ; Kuo, Ching Hua ; Lin, Mao Shin ; Kuo, Tien Chueh ; Tsai, Sung Jeng ; Liu, Pi Hua ; Lin, Cheng Hsin ; Yang, Chun Yi ; Chuang, Lee Ming ; Chen, Ming Fong ; Tseng, Yufeng J. ; Kao, Hsien Li. / Fasting but not changes of plasma metabolome during oral glucose tolerance tests improves the diagnosis of severe coronary arterial stenosis. In: Clinical Endocrinology. 2015 ; Vol. 83, No. 4. pp. 483-489.
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abstract = "Background Noninvasive stress tests for the diagnosis of significant coronary arterial stenosis requiring intervention are not perfect. We investigated whether plasma metabolome during the oral glucose tolerance test (OGTT) can improve the diagnosis. Methods A total of 117 subjects with positive stress test results who received coronary angiography were recruited. After excluding subjects with a history of myocardial infarction and subjects who did not receive OGTT, the 18 subjects without significant stenosis were selected as controls. Another 18 age- and sex-matched subjects with significant stenosis were selected as cases. Plasma metabolome from samples obtained in fasting, 30 and 120 min after OGTT was measured using liquid chromatography combined with time-of-flight mass spectrometry. Results We found five metabolites which can identify patients with significant stenosis independent to clinical risk factors, including diabetes, hypertension, hypercholesterolaemia, smoking and history of percutaneous coronary intervention (all P <0·05). The area under the receiver operating characteristic (AUROC) curve of these metabolites was 0·799-0·818 at fasting and 30 min after OGTT. The addition of metabolites to clinical factors increases the AUROC (0·616, 95{\%}CI 0·429-0·803 for model with clinical factors only; 0·824, 95{\%}CI 0·689-0·959 for model with four metabolites and clinical factors). The changes of plasma metabolite levels during OGTT did not significantly improve the diagnostic performance. Conclusions Fasting plasma metabolome, but not change of plasma metabolome during OGTT, can improve the diagnosis of significant stenosis in patients with positive noninvasive stress test results.",
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AU - Hung, Chi Sheng

AU - Li, Hung Yuan

AU - Kuo, Ching Hua

AU - Lin, Mao Shin

AU - Kuo, Tien Chueh

AU - Tsai, Sung Jeng

AU - Liu, Pi Hua

AU - Lin, Cheng Hsin

AU - Yang, Chun Yi

AU - Chuang, Lee Ming

AU - Chen, Ming Fong

AU - Tseng, Yufeng J.

AU - Kao, Hsien Li

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Y1 - 2015/10/1

N2 - Background Noninvasive stress tests for the diagnosis of significant coronary arterial stenosis requiring intervention are not perfect. We investigated whether plasma metabolome during the oral glucose tolerance test (OGTT) can improve the diagnosis. Methods A total of 117 subjects with positive stress test results who received coronary angiography were recruited. After excluding subjects with a history of myocardial infarction and subjects who did not receive OGTT, the 18 subjects without significant stenosis were selected as controls. Another 18 age- and sex-matched subjects with significant stenosis were selected as cases. Plasma metabolome from samples obtained in fasting, 30 and 120 min after OGTT was measured using liquid chromatography combined with time-of-flight mass spectrometry. Results We found five metabolites which can identify patients with significant stenosis independent to clinical risk factors, including diabetes, hypertension, hypercholesterolaemia, smoking and history of percutaneous coronary intervention (all P <0·05). The area under the receiver operating characteristic (AUROC) curve of these metabolites was 0·799-0·818 at fasting and 30 min after OGTT. The addition of metabolites to clinical factors increases the AUROC (0·616, 95%CI 0·429-0·803 for model with clinical factors only; 0·824, 95%CI 0·689-0·959 for model with four metabolites and clinical factors). The changes of plasma metabolite levels during OGTT did not significantly improve the diagnostic performance. Conclusions Fasting plasma metabolome, but not change of plasma metabolome during OGTT, can improve the diagnosis of significant stenosis in patients with positive noninvasive stress test results.

AB - Background Noninvasive stress tests for the diagnosis of significant coronary arterial stenosis requiring intervention are not perfect. We investigated whether plasma metabolome during the oral glucose tolerance test (OGTT) can improve the diagnosis. Methods A total of 117 subjects with positive stress test results who received coronary angiography were recruited. After excluding subjects with a history of myocardial infarction and subjects who did not receive OGTT, the 18 subjects without significant stenosis were selected as controls. Another 18 age- and sex-matched subjects with significant stenosis were selected as cases. Plasma metabolome from samples obtained in fasting, 30 and 120 min after OGTT was measured using liquid chromatography combined with time-of-flight mass spectrometry. Results We found five metabolites which can identify patients with significant stenosis independent to clinical risk factors, including diabetes, hypertension, hypercholesterolaemia, smoking and history of percutaneous coronary intervention (all P <0·05). The area under the receiver operating characteristic (AUROC) curve of these metabolites was 0·799-0·818 at fasting and 30 min after OGTT. The addition of metabolites to clinical factors increases the AUROC (0·616, 95%CI 0·429-0·803 for model with clinical factors only; 0·824, 95%CI 0·689-0·959 for model with four metabolites and clinical factors). The changes of plasma metabolite levels during OGTT did not significantly improve the diagnostic performance. Conclusions Fasting plasma metabolome, but not change of plasma metabolome during OGTT, can improve the diagnosis of significant stenosis in patients with positive noninvasive stress test results.

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