Albumin and fibrinogen kinetics in sepsis: a prospective observational study

Abstract Background The measurement of circulating substrate concentrations does not provide information about substrate kinetics. It, therefore, remains unclear if a decrease in plasma concentration of albumin, as seen during critical illness, is a consequence of suppressed production in the liver or increased peripheral clearance. In this study, using stable isotope tracer infusions, we measured albumin and fibrinogen kinetics in septic patients and in a control group of non-septic subjects. Methods With the approval from the institutional Research Ethics Board and after obtaining written informed consent from patients or their substitute decision maker, mechanically ventilated patients with sepsis and patients scheduled for elective coronary artery bypass grafting were enrolled. Patients in the non-sepsis group were studied on the day before surgery. The stable isotope L-[ring-2H5]phenylalanine was used to measure absolute synthesis rates (ASR) of albumin and fibrinogen. A priming dose of L-[ring-2H5]phenylalanine (4 µmol/kg) was given followed by a six-hour infusion at a rate of 0.15 µmol/kg/min. At baseline and hourly thereafter, blood was drawn to measure isotope enrichments by gas chromatography/mass spectrometry. Very low density lipoprotein apolipoprotein-B 100 isotopic enrichment was used to represent the isotopic enrichment of the phenylalanine precursor pool from which the liver synthesizes proteins. Plasma albumin and fibrinogen concentrations were also measured. Results Mean plasma albumin in septic patients was decreased when compared to non-septic patients, while synthesis rates were comparable. Mean plasma fibrinogen and ASR in septic patients was increased when compared to non-septic patients. In non-septic patients, no statistically significant correlation between plasma albumin and ASR was observed but plasma fibrinogen significantly correlated with ASR. In septic patients, plasma albumin and fibrinogen significantly correlated with ASR. Conclusions While septic patients showed lower plasma albumin levels than non-septic patients, albumin synthesis was similar in the two groups suggesting that hypoalbuminemia during sepsis was not caused by suppressed hepatic production but a result of enhanced clearance from the circulation. Hyperfibrinogenemia in septic patients was a consequence of increased fibrinogen production. Trial registration: ClinicalTrials.gov: NCT02865408 (registered on August 12, 2016) and ClinicalTrials.gov: NCT02549443 (registered on September 15, 2015).

Download Full-text

HUBUNGAN KADAR ALBUMIN PLASMA DAN GULA DARAH DENGAN SEPSIS NEONATORUM

Jurnal e-Biomedik ◽

10.35790/ebm.1.1.2013.1623 ◽

2013 ◽

Vol 1 (1) ◽

Author(s):

Ester Elisabeth Wowor ◽

Johnny Rompis ◽

Rocky Wilar

Keyword(s):

Blood Glucose ◽

Neonatal Sepsis ◽

Clinical Symptoms ◽

Sepsis Group ◽

Control Group ◽

Plasma Albumin ◽

Chi Square ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Significant Difference

Abstract. Sepsis is the most leading cause of morbidity and mortality in neonates. In sepsis, the proinflammatory cytokines realeasing leads to disruption of plasma albumin and blood glucose levels. This study aim to analyze the relationship of plasma albumin and blood sugar levels with neonatal sepsis. Prospective observational analytic studies conducted on suspected sepsis neonates at Pediatrics Department Sub Division Neonatology RSUP Prof.Kandou Manado. Diagnosis of sepsis based on clinical symptoms and laboratory tests. Subjects are grouped into two groups of neonatal sepsis and non-neonatal sepsis group (control group). Plasma albumin and blood glucose level examined, then statistically analyzed. The statistical analysis used was Pearson Chi-Square correlation and Fisher Exact. The data were processed using SPSS 21. The results of this study indicate that hypoalbuminemia was found in 12 (75%) of 16 neonatal sepsis subject, whereas in non-neonatal sepsis only found 5 (22,7%) of 22 non-sepsis subjects. Statistically there is a highly significant difference (p=0,001). For the impaired blood glucose (both hypoglycemia or hyperglycemia) there is no significant difference between the two groups (p=0,466).Conclusion: There is a highly significant relationship between hypoalbuminemia with neonatal sepsis. There was no significant correlation between abnormal blood glucose levels with neonatal sepsis. Keywords: neonatal sepsis, plasma albumin levels, blood glucose levels Abstrak.Sepsis merupakan penyebab morbiditas dan mortalitas terbanyak pada neonatus. Pada sepsis terjadi pelepasan sitokin proinflamasi yang memicu terjadinya gangguan kadar albumin plasma dan kadar glukosa darah.Menganalisis hubungan kadar albumin plasma dan kadar gula darah dengan sepsis neonatorum.Penelitian analitik observasional prospektif dilakukanpada tersangka sepsis neonatorum yang dirawat di bagian Ilmu Kesehatan Anak Sub Bagian Neonati RSUP Prof. Dr. R.D. Kandou Manado. Diagnosis sepsis berdasarkan gejala klinik dan pemeriksaan laboratorium. Subyek penelitian dikelompokkan menjadi kelompok sepsis neonatorum dan kelompok non sepsis neonatorum (kelompok kontrol). Dilakukan pemeriksaan kadar albumin plasma dan glukosa darah, kemudian dianalasis secara statistik. Analisis statistik yang digunakan adalah uji korelasi Pearson Chi-Square dan uji Fisher Exact. Data diolah dengan menggunakan program SPSS 21.Hasil penelitian menunjukkan bahwa hipoalbuminemia ditemukan pada 12 (75%) dari 16 penderita sepsis neonatorum, sedangkan pada penderita non sepsis hanya ditemukan 5 (22,7%) dari 22 penderita non sepsis. Secara statistik terdapat perbedaan yang sangat bermakna (p=0,001). sedangkan gangguan glukosa darah (baik hipoglikemia maupun hiperglikemia) tidak terdapat perbedaan yang bermaknsa antara kedua kelompok (p=0,466).Simpulan:Terdapat hubungan yang sangat bermakna antara hipoalbuminemia dengan sepsis neonatorum. Tidak terdapat hubungan yang bermakna antara kadar gula darah abnormal dengan sepsis neonatorum. Kata Kunci:sepsis neonatorum, kadar albumin plasma, kadar glukosa darah

Download Full-text

Acute and Chronic Changes in Platelet Volume and Count After Cardiopulmonary Bypass Induced Thrombocytopenia in Man

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651061 ◽

1987 ◽

Vol 57 (01) ◽

pp. 55-58 ◽

Cited By ~ 37

Author(s):

J F Martin ◽

T D Daniel ◽

E A Trowbridge

Keyword(s):

Platelet Count ◽

Mean Platelet Volume ◽

Artery Bypass ◽

Bypass Graft ◽

Control Group ◽

Artery Bypass Graft ◽

Platelet Volume ◽

Young Males ◽

The Mean

SummaryPatients undergoing surgery for coronary artery bypass graft or heart valve replacement had their platelet count and mean volume measured pre-operatively, immediately post-operatively and serially for up to 48 days after the surgical procedure. The mean pre-operative platelet count of 1.95 ± 0.11 × 1011/1 (n = 26) fell significantly to 1.35 ± 0.09 × 1011/1 immediately post-operatively (p <0.001) (n = 22), without a significant alteration in the mean platelet volume. The average platelet count rose to a maximum of 5.07 ± 0.66 × 1011/1 between days 14 and 17 after surgery while the average mean platelet volume fell from preparative and post-operative values of 7.25 ± 0.14 and 7.20 ± 0.14 fl respectively to a minimum of 6.16 ± 0.16 fl by day 20. Seven patients were followed for 32 days or longer after the operation. By this time they had achieved steady state thrombopoiesis and their average platelet count was 2.44 ± 0.33 × 1011/1, significantly higher than the pre-operative value (p <0.05), while their average mean platelet volume was 6.63 ± 0.21 fl, significantly lower than before surgery (p <0.001). The pre-operative values for the platelet volume and counts of these patients were significantly different from a control group of 32 young males, while the chronic post-operative values were not. These long term changes in platelet volume and count may reflect changes in the thrombopoietic control system secondary to the corrective surgery.

Download Full-text

Bovine Platelet Proteins

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653555 ◽

1969 ◽

Vol 21 (03) ◽

pp. 409-418 ◽

Cited By ~ 2

Author(s):

S Łopaciuk ◽

N. O Solum

Keyword(s):

Bovine Serum ◽

Protein Composition ◽

Disc Electrophoresis ◽

Plasma Fibrinogen ◽

Plasma Albumin ◽

Precipitin Line ◽

Bovine Plasma ◽

Platelet Proteins

Summary1. The protein composition of bovine platelet extracts has been investigated by immunoelectrophoresis and polyacrylamide disc electrophoresis. The information obtained is discussed as a basis for study on platelet fibrinogen.2. With antiserum to platelet proteins 11 precipitin lines were observed 3 of which corresponded electrophoretically to plasma albumin, fibrinogen and γ-globulin. These lines were not seen using the same antiserum absorbed with bovine plasma. The 8 additional lines were still present indicating that they represented specific platelet components. Antiserum to plasma produced the 3 above-mentioned lines, but no others.3. With antiserum to purified bovine plasma fibrinogen 3 precipitin lines were observed. The fibrinogen line was the dominant one. The 2 additional lines did not disappear by absorption of the antiserum with bovine serum nor by incubation of the extracts with thrombin. The latter treatment totally removed the fibrinogen line.4. A non-fibrinogen precipitin line, observed only with the antiserum to platelet extract and positioned in the β2-globulin region, disappeared by the incubation of platelet extracts with thrombin.

Download Full-text

Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

The Heart Surgery Forum ◽

10.1532/hsf.1367 ◽

2015 ◽

Vol 18 (4) ◽

pp. 171 ◽

Cited By ~ 1

Author(s):

Tolga Demir ◽

Mehmet Umit Ergenoglu ◽

Hale Bolgi Demir ◽

Nursen Tanrikulu ◽

Mazlum Sahin ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Myocardial Protection ◽

Troponin T ◽

Artery Bypass ◽

Control Group ◽

Study Group ◽

Cabg Surgery ◽

Anti Inflammatory ◽

Pump Coronary Artery Bypass

Background: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an anti-inflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB). Methods: Forty patients who were scheduled for elective CABG surgery were randomized into two groups: the study group (n = 20), who received 1 g of methylprednisolone intravenously before CPB, and the control group (n = 20), who underwent a standard CABG surgery without any additional medication. Blood samples were withdrawn prior to surgery (T1) and then 4 hours (T2), 24 hours (T3), and 36 hours (T4) after CPB. Plasma levels of interleukin (IL)-6, IL-10, creatine kinase isoenzyme MB (CK-MB), cardiac troponin-t (cTnT), and blood glucose as well as neutrophil counts were measured at each sampling time. Results: A comparison of patients between both groups revealed significantly high levels of IL-6 in the control group at T2, T3, and T4 with respect to T1 (T2: P < .001; T3: P < .001; T4: P < .001). IL-10 levels were significantly higher in the study group at T2 compared with the control group (P = .007). CK-MB levels were significantly lower in the study group than in the control group at T4 (P = .001). The increase of cTnT was higher in the control group at T3 and T4 compared with the study group (T3: P = .002; T4: P = .001). Conclusions: This study demonstrates that methylprednisolone is effective for ensuring better myocardial protection during cardiac surgery by suppressing the inflammatory response via decreasing the levels of IL-6 and by increasing anti-inflammatory activity through IL-10.

Download Full-text

The Use of Posterior Pericardiotomy Technique to Prevent Postoperative Pericardial Effusion in Cardiac Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.20111128 ◽

2012 ◽

Vol 15 (2) ◽

pp. 84 ◽

Cited By ~ 4

Author(s):

Canturk Cakalagaoglu ◽

Cengiz Koksal ◽

Ayse Baysal ◽

Gokhan Alici ◽

Birol Ozkan ◽

...

Keyword(s):

Cardiac Surgery ◽

Heart Surgery ◽

Artery Bypass ◽

Pericardial Tamponade ◽

Anxiety Level ◽

Control Group ◽

Echocardiographic Study ◽

Number Of Patients ◽

Hospital Stays

Aim: The goal was to determine the effectiveness of the posterior pericardiotomy technique in preventing the development of early and late pericardial effusions (PEs) and to determine the role of anxiety level for the detection of late pericardial tamponade (PT).Materials and Methods: We divided 100 patients randomly into 2 groups, the posterior pericardiotomy group (n = 50) and the control group (n = 50). All patients undergoing coronary artery bypass grafting surgery (CABG), valvular heart surgery, or combined valvular and CABG surgeries were included. The posterior pericardiotomy technique was performed in the first group of 50 patients. Evaluations completed preoperatively, postoperatively on day 1, before discharge, and on postoperative days 5 and 30 included electrocardiographic study, chest radiography, echocardiographic study, and evaluation of the patient's anxiety level. Postoperative causes of morbidity and durations of intensive care unit and hospital stays were recorded.Results: The 2 groups were not significantly different with respect to demographic and operative data (P > .05). Echocardiography evaluations revealed no significant differences between the groups preoperatively; however, before discharge the control group had a significantly higher number of patients with moderate, large, and very large PEs compared with the pericardiotomy group (P < .01). There were 6 cases of late PT in the control group, whereas there were none in the pericardiotomy group (P < .05). Before discharge and on postoperative day 15, the patients in the pericardiotomy group showed significant improvement in anxiety levels (P = .03 and .004, respectively). No differences in postoperative complications were observed between the 2 groups.Conclusion: Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.

Download Full-text

Effect of Tai Chi Training on Plantar Loads during Walking in Individuals with Knee Osteoarthritis

BioMed Research International ◽

10.1155/2020/3096237 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Zhiwang Zhang ◽

Lingyan Huang ◽

Yu Liu ◽

Lin Wang

Keyword(s):

Clinical Trials ◽

Knee Osteoarthritis ◽

Education Program ◽

Tai Chi ◽

Peak Pressure ◽

Maximum Force ◽

Control Group ◽

Link Type ◽

Wellness Education ◽

Metatarsophalangeal Joints

Tai Chi is an available method for the treatment of knee osteoarthritis (KOA). The impacts of Tai Chi on plantar loads of individuals with KOA are not fully understood. 46 participants with knee osteoarthritis were randomly assigned into the Tai Chi group (n=23) or the control group (n=23). The Tai Chi group attended a 6-month Tai Chi program, and the control group participated in a wellness education program. Novel Pedar-X system was used to collect the peak pressure (PP) and maximum force (MF) during walking before and 6 months after the intervention. Significant higher peak pressure and maximum force were observed in the 4th and 5th metatarsophalangeal joints in the Tai Chi group. However, there were significant declines in the peak pressure of the whole foot and the 2nd and 3rd metatarsophalangeal joints and maximum force of the heel in the control group. These results suggested that individuals with KOA might change the pattern of plantar loads during walking through Tai Chi, and plantar loads would be useful as a parameter to assess the effect of Tai Chi on knee osteoarthritis. This trial is registered with Clinical Trials: CHiCTR-TRC-13003264.

Download Full-text

Retinal vascular fractal dimensions and their association with macrovascular cardiac disease.

Ophthalmic Research ◽

10.1159/000514442 ◽

2021 ◽

Author(s):

Sebastian Dinesen ◽

Pia Søndergaard Jensen ◽

Maria Bloksgaard ◽

Søren Leer Blindbæk ◽

Jo G.R. De Mey ◽

...

Keyword(s):

Confidence Interval ◽

Cardiac Disease ◽

Artery Bypass ◽

Fractal Dimensions ◽

Macrovascular Disease ◽

Control Group ◽

Vascular Structure ◽

Non Invasive ◽

Automatic Software ◽

Multivariable Regression

Introduction As the only part of the human vasculature, retina is available for direct, non-invasive inspection. Retinal vascular fractal dimension (DF) is a method to measure the structure of the retinal vascular tree, with higher non-integer values between 1 and 2 representing a more complex and dense retinal vasculature. Retinal vascular structure has been associated with a variety of systemic diseases and this study examined the association of DF and macrovascular cardiac disease in a case-control design. Methods Retinal fundus photos were captured with Topcon TRC-50X in 38 persons that had coronary artery bypass grafting (CABG, cases) and 37 cardiovascular healthy controls. The semi-automatic software VAMPIRE was used to measure retinal DF. Results Patients with CABG had lower DF of the retinal main venular vessels compared to the control group (1.15 vs. 1.18, p=0.01). In a multivariable regression model adjusted for gender and age, eyes in the fourth quartile with higher DF were less likely to have CABG compared to patients in the first (OR, 7.20; 95% confidence interval, 1.63 to 31.86; p=0.009) and second quartile (OR, 8.25; 95% confidence interval, 1.70 to 40.01; p=0.009). Conclusions This study demonstrates that lower complexity of main venular vessels associates with higher risk of having CABG. The research supports the hypothesis that the retinal vascular structure can be used to assess non-ocular macrovascular disease.

Download Full-text

Effects of remote ischemic conditioning on microcirculatory alterations in patients with sepsis: a single-arm clinical trial

Annals of Intensive Care ◽

10.1186/s13613-021-00848-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Inga Kiudulaite ◽

Egle Belousoviene ◽

Astra Vitkauskiene ◽

Andrius Pranskunas

Keyword(s):

Dark Field ◽

Historical Control ◽

Flow Index ◽

Control Group ◽

Remote Ischemic Conditioning ◽

Ischemic Conditioning ◽

Sublingual Microcirculation ◽

Link Type ◽

Microcirculatory Flow ◽

Tertiary Teaching

Abstract Background Remote ischemic conditioning (RIC) is a promising technique that may protect organs and tissues from the effects of additional ischemic episodes. However, the therapeutic efficacy of RIC in humans with sepsis remains unknown. We hypothesized that RIC might improve sublingual microcirculation in patients with sepsis. Methods This prospective single-arm trial was performed in a mixed ICU at a tertiary teaching hospital. We included patients with sepsis or septic shock within 24 h of ICU admission. The RIC procedure comprised 3 cycles of brachial cuff inflation to 200 mmHg for 5 min followed by deflation to 0 mmHg for another 5 min. The procedure took 30 min. RIC was performed at the time of study inclusion and repeated after 12 and 24 h. Sublingual microcirculatory measurements were obtained before and after each RIC procedure using a Cytocam®-incident dark-field (IDF) device (Braedius Medical, Huizen, The Netherlands). The microcirculatory data were compared with a historical control. Data are reported as the medians along with the 25th and 75th percentiles. Results Twenty-six septic patients with a median age of 65 (57–81) years were enrolled in this study. The median Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at admission were 20 (13–23) and 10 (9–12), respectively. All patients were receiving vasopressors. After the 1st RIC procedure, the microvascular flow index (MFI) and the proportion of perfused vessels (PPV) among small vessels were significantly higher than before the procedure, with pre- and post-treatment values of 2.17 (1.81–2.69) and 2.59 (2.21–2.83), respectively, for MFI (p = 0.003) and 87.9 (82.4–93.8) and 92.5 (87.9–96.1) %, respectively, for PPV (p = 0.026). This result was confirmed by comparison with a historical control group. We found no change in microcirculatory flow or density parameters during repeated RIC after 12 h and 24 h. Conclusion In patients with sepsis, the first remote ischemic conditioning procedure improved microcirculatory flow, whereas later procedures did not affect sublingual microcirculation. Trial registration NCT04644926, http://www.clinicaltrials.gov. Date of registration: 25 November 2020. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04644926.

Download Full-text

Frequency of repositioning for preventing pressure ulcers in patients hospitalized in ICU: protocol of a cluster randomized controlled trial

BMC Nursing ◽

10.1186/s12912-021-00616-0 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Olga L. Cortés ◽

Mauricio Herrera-Galindo ◽

Juan Carlos Villar ◽

Yudi A. Rojas ◽

María del Pilar Paipa ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Critical Care ◽

Pressure Ulcers ◽

Controlled Trial ◽

Cluster Randomized Controlled Trial ◽

Control Group ◽

Randomized Controlled ◽

Link Type ◽

Cluster Randomized ◽

The Impact

Abstract Background Despite being considered preventable, ulcers due to pressure affect between 30 and 50% of patients at high and very high risk and susceptibility, especially those hospitalized under critical care. Despite a lack of evidence over the efficacy in prevention against ulcers due to pressure, hourly repositioning in critical care as an intervention is used with more or less frequency to alleviate pressure on patients’ tissues. This brings up the objective of our study, which is to evaluate the efficacy in prevention of ulcers due to pressure acquired during hospitalization, specifically regarding two frequency levels of repositioning or manual posture switching in adults hospitalized in different intensive care units in different Colombian hospitals. Methods A nurse-applied cluster randomized controlled trial of parallel groups (two branches), in which 22 eligible ICUs (each consisting of 150 patients), will be randomized to a high-frequency level repositioning intervention or to a conventional care (control group). Patients will be followed until their exit from each cluster. The primary result of this study is originated by regarding pressure ulcers using clusters (number of first ulcers per patient, at the early stage of progression, first one acquired after admission for 1000 days). The secondary results include evaluating the risk index on the patients’ level (Hazard ratio, 95% IC) and a description of repositioning complications. Two interim analyses will be performed through the course of this study. A statistical difference between the groups < 0.05 in the main outcome, the progression of ulcers due to pressure (best or worst outcome in the experimental group), will determine whether the study should be put to a halt/determine the termination of the study. Conclusion This study is innovative in its use of clusters to advance knowledge of the impact of repositioning as a prevention strategy against the appearance of ulcers caused by pressure in critical care patients. The resulting recommendations of this study can be used for future clinical practice guidelines in prevention and safety for patients at risk. Trial registration PENFUP phase-2 was Registered in Clinicaltrials.gov (NCT04604665) in October 2020.

Download Full-text

Gut Microbiome and Metabolome Profiles Associated with High-Fat Diet in Mice

Metabolites ◽

10.3390/metabo11080482 ◽

2021 ◽

Vol 11 (8) ◽

pp. 482

Author(s):

Jae-Kwon Jo ◽

Seung-Ho Seo ◽

Seong-Eun Park ◽

Hyun-Woo Kim ◽

Eun-Ju Kim ◽

...

Keyword(s):

Gut Microbiota ◽

Relative Abundance ◽

High Fat Diet ◽

Amplicon Sequencing ◽

Gas Chromatography Mass Spectrometry ◽

Control Group ◽

Rrna Gene ◽

High Fat ◽

Underlying Mechanisms ◽

Insight Into

Obesity can be caused by microbes producing metabolites; it is thus important to determine the correlation between gut microbes and metabolites. This study aimed to identify gut microbiota-metabolomic signatures that change with a high-fat diet and understand the underlying mechanisms. To investigate the profiles of the gut microbiota and metabolites that changed after a 60% fat diet for 8 weeks, 16S rRNA gene amplicon sequencing and gas chromatography-mass spectrometry (GC-MS)-based metabolomic analyses were performed. Mice belonging to the HFD group showed a significant decrease in the relative abundance of Bacteroidetes but an increase in the relative abundance of Firmicutes compared to the control group. The relative abundance of Firmicutes, such as Lactococcus, Blautia, Lachnoclostridium, Oscillibacter, Ruminiclostridium, Harryflintia, Lactobacillus, Oscillospira, and Erysipelatoclostridium, was significantly higher in the HFD group than in the control group. The increased relative abundance of Firmicutes in the HFD group was positively correlated with fecal ribose, hypoxanthine, fructose, glycolic acid, ornithine, serum inositol, tyrosine, and glycine. Metabolic pathways affected by a high fat diet on serum were involved in aminoacyl-tRNA biosynthesis, glycine, serine and threonine metabolism, cysteine and methionine metabolism, glyoxylate and dicarboxylate metabolism, and phenylalanine, tyrosine, and trypto-phan biosynthesis. This study provides insight into the dysbiosis of gut microbiota and metabolites altered by HFD and may help to understand the mechanisms underlying obesity mediated by gut microbiota.

Download Full-text