Am J Clin Nutr:饮食因素、肠道菌群和血清氧化三甲胺与心血管疾病的关系

2021-04-05 Dr.Sun Nutrition & Health MedSci原创

氧化三甲胺(TMAO)是一种可能来源于饮食并与肠道菌群(GMB)相关的代谢产物,在大量临床研究中,它与心血管疾病(CVD)风险增加有关,独立于传统的危险因素。环境和宿主因素,例如GMB、饮食摄入量和宿

氧化三甲胺(TMAO)是一种可能来源于饮食并与肠道菌群(GMB)相关的代谢产物,在大量临床研究中,它与血管疾病(CVD)风险增加有关,独立于传统的危险因素。环境和宿主因素,例如GMB、饮食摄入量和宿主遗传,被认为独立和共同影响TMAO的循环浓度,但基于人群的研究数据仍然有限。确定改变循环TMAO的潜在驱动因素可能会对CVD具有预防和治疗意义。

含有三甲胺(TMA)的营养物质,包括胆碱、磷酰胆碱、肉碱和甜菜碱,在红肉(如牛肉和猪肉)和鸡蛋等动物性食品中含量丰富,可以通过一系列生理过程在人体内转化为TMAO。除了由饮食前体产生的TMAO外,预先形成的TMAO还能够以不涉及人类和动物肠道细菌的方式吸收。然而,评估饮食因素与TMAO之间关系的人群研究还没有定论,这可能是由于不同人群的饮食习惯、GMB或宿主遗传背景的差异。循环TMAO的主要饮食决定因素仍然有待人群研究。

至于GMB在调节循环TMAO中的作用,研究发现抗生素可以抑制小鼠和人类的血液TMAO浓度。最近利用16S rRNA基因扩增子测序(16S)数据的两项研究确定了与循环TMAO相关的几个GMB特征(例如梭菌目、双歧杆菌目和拟杆菌目中的属)。然而,能够将含有TMA的营养物质代谢成TMA从而提升宿主TMAO浓度的特定肠道细菌分类,仍有待于在人群中确定。此外,影响循环TMAO浓度的GMB与饮食因素(如红肉摄入量)之间的潜在相互作用也尚未在人群中探索。

近日,发表在The American Journal of Clinical Nutrition杂志上的一项研究,来自上海复旦大学和美国阿尔伯特·爱因斯坦医学院等机构的研究人员对以下目标进行了研究:1)检查血清TMAO和前体代谢物(胆碱、肉碱和甜菜碱)与流行性CVD的关联;2)检查饮食因素与血清TMAO和前体代谢物浓度的关联;以及3)确定与血清TMAO相关的GMB特征。

这项横断面研究纳入3972名18岁-74岁的参与者(57.3%为女性),他们来自美国的西班牙裔社区健康研究/拉美裔研究。饮食信息在基线访谈时(2008-2011年)通过24小时饮食回顾法进行收集,基线血清TMAO及其前体通过非靶向方法进行测定。肠道菌群在随访(2016-2018年)中通过鸟枪法宏基因组测序在一个参与者亚组(n = 626)中进行分析。在对社会人口学、行为和临床因素进行调整后,使用逻辑回归和线性回归检验逆正态代谢物分别与流行性CVD、饮食摄入量和细菌菌种之间的关联。

研究结果

参与者特征

与TMAO浓度较低的参与者相比,TMAO浓度较高的参与者年龄较大,是女性的可能性较小,更有可能当前吸烟,平均BMI和饮食能量摄入量较高,并且更有可能患糖尿病、高血压和血脂异常。

TMAO代谢物和心血管疾病(CVD)

不出所料,这4个代谢物除了胆碱和肉碱之间缺乏相关性之外,彼此之间表现出轻度至中度的相关性。血清TMAO与心血管疾病(CVD)、冠状动脉心脏病(CHD)和脑血管疾病或颈动脉血管重建术(CDCR)的几率升高相关。

饮食和TMAO代谢物

研究人员接下来评估了饮食因素与血清TMAO及其前体代谢物浓度的关联。在对社会人口学和行为因素加上病史进行多变量调整后,红肉、鱼和鸡蛋的摄入量增加与TMAO浓度升高密切相关,而家禽、乳制品和加工肉的摄入量与血清TMAO呈反相关。此外,鸡蛋和精制谷物摄入量与血清胆碱和甜菜碱呈正相关。红肉摄入量与血清肉碱呈正相关。而鱼摄入量与任何这些TMAO前体都无关。

食品组与血清TMAO及其前体代谢物的关联。(A)在3466名个体中15个食品组与血清TMAO及其前体代谢物的关联。(B)在3466名个体中鱼、红肉和鸡蛋摄入量全部五分位数的循环TMAO及其前体代谢物浓度。

肠道菌群(GMB)和TMAO

研究确定了9种与TMAO有显著关联的肠道菌种(假发现率<0.05)。所有4个与TMAO正相关的种类都属于梭菌目,其中3个可能具有编码肉碱单加氧酶的同源基因,肉碱单加氧酶是一种将肉碱转化为三甲胺(TMA)的酶。

与血清TMAO浓度相关的分类特征的系统进化树

与丰度较低的参与者(Pinteraction = 0.013)相比,这4个菌种丰度较高的参与者中红肉-TMAO关联更加显著,但这种细菌修饰在鱼-TMAO或鸡蛋-TMAO关联中没有观察到。

根据GMB评分,鱼、红肉和鸡蛋摄入量与TMAO的关联

这项分析表明了人群中循环TMAOGMB依赖性(如红肉)和GMB非依赖性(如鱼类)饮食来源。GMB依赖性TMAO,即由肠道细菌代谢生成的部分,主要来自饮食胆碱和肉碱,两者都富含于鸡蛋、肝脏和各种肉类中。然而,TMAO也天然存在于海鲜中,处于预先形成的状态。此研究发现为人体循环中TMAO2条主要途径提供了强有力的支持。

在这项研究中观察到的细菌对红肉-TMAO关联的显著修饰进一步支持了已确定的肠道菌种及其从肉碱生成TMA的潜力。这一发现表明,红肉与循环TMAO之间的正相关性取决于这些肠道细菌分类,它们有助于将膳食红肉中的肉碱加工成TMA研究没有发现鱼摄入量和血清TMAO之间的关联存在这种微生物修饰,进一步支持鱼作为循环TMAOGMB非依赖性饮食来源。研究也没有发现摄入鸡蛋这种胆碱的主要饮食来源与血清TMAO之间的关联存在这种细菌修饰,这符合研究的细菌基因比对结果,即这些肠道菌种含有肉碱单加氧酶基因(cntA/B),而不是胆碱TMA-裂解酶基因。

然而,由于这项和以前的研究证明了摄入鸡蛋和循环TMAO之间的剂量-反应关系,需要进一步研究,以澄清肠道细菌途径,将食用鸡蛋和胆碱与人体中细菌生成TMATMAO联系起来。

这项研究还确定了一些与血清TMAO呈负相关的肠道菌种。其中,值得注意的是,双歧杆菌Bifidobacterium saguini和其他几个属于双歧杆菌属的菌种,双歧杆菌属被广泛报道与人体和小鼠循环TMAO浓度呈负相关。

总之,这项研究发现氧化三甲胺(TMAO)与心血管疾病之间存在横断面关联,并表明鱼、红肉和鸡蛋的摄入量是美国西班牙裔/拉美裔循环TMAO浓度的主要饮食决定因素。研究发现了几个可能具有三甲胺生成潜力的肠道菌种,这些菌种与血清TMAO呈正相关。此外,红肉摄入量和血清TMAO之间的关联可能取决于这些特定的肠道菌种,支持肠道菌群在从饮食肉碱生成TMA和TMAO中具有重要的作用。这些发现从人群研究提供了证据,支持饮食来源的TMAO以肠道菌群非依赖性和肠道菌群依赖性的方式在人体循环中形成。这反过来又可能对今后通过调整饮食和肠道菌群预防人群中与这一途径相关的CVD的努力产生重要影响。

原始出处:

Zhendong Mei, Guo-Chong Chen et al. Dietary factors, gut microbiota, and serum trimethylamine-N-oxide associated with cardiovascular disease in the Hispanic Community Health Study/Study of Latinos. J Clin Nutr. 2021 Mar 11;nqab001. doi: 10.1093/ajcn/nqab001. Online ahead of print.

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  3. [GetPortalCommentsPageByObjectIdResponse(id=1821086, encodeId=2cb818210866b, content=<a href='/topic/show?id=d33a1012290d' target=_blank style='color:#2F92EE;'>#饮食因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101229, encryptionId=d33a1012290d, topicName=饮食因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun Feb 27 00:16:09 CST 2022, time=2022-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1392432, encodeId=000913924328a, content=<a href='/topic/show?id=223081e33b6' target=_blank style='color:#2F92EE;'>#肠道菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81733, encryptionId=223081e33b6, topicName=肠道菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa292500107, createdName=1249897bm37(暂无昵称), createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498856, encodeId=31ed1498856a2, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552542, encodeId=b6e415525425b, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954198, encodeId=042595419805, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/2449ca6b339a462c8c32830bff2ffaf4/0c25cb3e8d9c4a79a9a4659a744892e7.jpg, createdBy=67a02288007, createdName=melissaxy, createdTime=Tue Apr 06 13:54:15 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954087, encodeId=7e8895408e73, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/4e17700ebbac43d0a83b27157380f879/88a568d6b99c4089872c5383a4aec082.jpg, createdBy=e2635477181, createdName=ms3000000317925001, createdTime=Tue Apr 06 07:52:05 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954076, encodeId=39679540e6fe, content=收藏了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e735477166, createdName=ms9000001883355653, createdTime=Tue Apr 06 01:45:31 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954063, encodeId=efbc954063fc, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210405/c0701935a2ce4be3b2674cc7a39fda3b/4cc95797da3b4488a48257e6ce67f6a0.jpg, createdBy=c0d15464145, createdName=ms9000001076948931, createdTime=Mon Apr 05 23:09:50 CST 2021, time=2021-04-05, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1821086, encodeId=2cb818210866b, content=<a href='/topic/show?id=d33a1012290d' target=_blank style='color:#2F92EE;'>#饮食因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101229, encryptionId=d33a1012290d, topicName=饮食因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun Feb 27 00:16:09 CST 2022, time=2022-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1392432, encodeId=000913924328a, content=<a href='/topic/show?id=223081e33b6' target=_blank style='color:#2F92EE;'>#肠道菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81733, encryptionId=223081e33b6, topicName=肠道菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa292500107, createdName=1249897bm37(暂无昵称), createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498856, encodeId=31ed1498856a2, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552542, encodeId=b6e415525425b, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954198, encodeId=042595419805, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/2449ca6b339a462c8c32830bff2ffaf4/0c25cb3e8d9c4a79a9a4659a744892e7.jpg, createdBy=67a02288007, createdName=melissaxy, createdTime=Tue Apr 06 13:54:15 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954087, encodeId=7e8895408e73, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/4e17700ebbac43d0a83b27157380f879/88a568d6b99c4089872c5383a4aec082.jpg, createdBy=e2635477181, createdName=ms3000000317925001, createdTime=Tue Apr 06 07:52:05 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954076, encodeId=39679540e6fe, content=收藏了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e735477166, createdName=ms9000001883355653, createdTime=Tue Apr 06 01:45:31 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954063, encodeId=efbc954063fc, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210405/c0701935a2ce4be3b2674cc7a39fda3b/4cc95797da3b4488a48257e6ce67f6a0.jpg, createdBy=c0d15464145, createdName=ms9000001076948931, createdTime=Mon Apr 05 23:09:50 CST 2021, time=2021-04-05, status=1, ipAttribution=)]
    2021-04-07 陈吴1239
  5. [GetPortalCommentsPageByObjectIdResponse(id=1821086, encodeId=2cb818210866b, content=<a href='/topic/show?id=d33a1012290d' target=_blank style='color:#2F92EE;'>#饮食因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101229, encryptionId=d33a1012290d, topicName=饮食因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun Feb 27 00:16:09 CST 2022, time=2022-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1392432, encodeId=000913924328a, content=<a href='/topic/show?id=223081e33b6' target=_blank style='color:#2F92EE;'>#肠道菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81733, encryptionId=223081e33b6, topicName=肠道菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa292500107, createdName=1249897bm37(暂无昵称), createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498856, encodeId=31ed1498856a2, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552542, encodeId=b6e415525425b, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954198, encodeId=042595419805, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/2449ca6b339a462c8c32830bff2ffaf4/0c25cb3e8d9c4a79a9a4659a744892e7.jpg, createdBy=67a02288007, createdName=melissaxy, createdTime=Tue Apr 06 13:54:15 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954087, encodeId=7e8895408e73, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/4e17700ebbac43d0a83b27157380f879/88a568d6b99c4089872c5383a4aec082.jpg, createdBy=e2635477181, createdName=ms3000000317925001, createdTime=Tue Apr 06 07:52:05 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954076, encodeId=39679540e6fe, content=收藏了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e735477166, createdName=ms9000001883355653, createdTime=Tue Apr 06 01:45:31 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954063, encodeId=efbc954063fc, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210405/c0701935a2ce4be3b2674cc7a39fda3b/4cc95797da3b4488a48257e6ce67f6a0.jpg, createdBy=c0d15464145, createdName=ms9000001076948931, createdTime=Mon Apr 05 23:09:50 CST 2021, time=2021-04-05, status=1, ipAttribution=)]
    2021-04-06 melissaxy

    好文章

    0

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    2021-04-06 ms3000000317925001

    👍

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1821086, encodeId=2cb818210866b, content=<a href='/topic/show?id=d33a1012290d' target=_blank style='color:#2F92EE;'>#饮食因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101229, encryptionId=d33a1012290d, topicName=饮食因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Sun Feb 27 00:16:09 CST 2022, time=2022-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1392432, encodeId=000913924328a, content=<a href='/topic/show?id=223081e33b6' target=_blank style='color:#2F92EE;'>#肠道菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81733, encryptionId=223081e33b6, topicName=肠道菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa292500107, createdName=1249897bm37(暂无昵称), createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498856, encodeId=31ed1498856a2, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552542, encodeId=b6e415525425b, content=<a href='/topic/show?id=a8d5196997c' target=_blank style='color:#2F92EE;'>#三甲#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19699, encryptionId=a8d5196997c, topicName=三甲)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=88e914287502, createdName=陈吴1239, createdTime=Wed Apr 07 12:16:09 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954198, encodeId=042595419805, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/2449ca6b339a462c8c32830bff2ffaf4/0c25cb3e8d9c4a79a9a4659a744892e7.jpg, createdBy=67a02288007, createdName=melissaxy, createdTime=Tue Apr 06 13:54:15 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954087, encodeId=7e8895408e73, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210406/4e17700ebbac43d0a83b27157380f879/88a568d6b99c4089872c5383a4aec082.jpg, createdBy=e2635477181, createdName=ms3000000317925001, createdTime=Tue Apr 06 07:52:05 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954076, encodeId=39679540e6fe, content=收藏了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7e735477166, createdName=ms9000001883355653, createdTime=Tue Apr 06 01:45:31 CST 2021, time=2021-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=954063, encodeId=efbc954063fc, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210405/c0701935a2ce4be3b2674cc7a39fda3b/4cc95797da3b4488a48257e6ce67f6a0.jpg, createdBy=c0d15464145, createdName=ms9000001076948931, createdTime=Mon Apr 05 23:09:50 CST 2021, time=2021-04-05, status=1, ipAttribution=)]
    2021-04-06 ms9000001883355653

    收藏了

    0

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    2021-04-05 ms9000001076948931

    好文章

    0

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