Vascular surgery patients have reduced tissues` blood supply, which may lead to mitochondrial dysfunction and accumulation of acylcarnitines (ACs). It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function. The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients. This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open surgical repair of abdominal aortic aneurysm, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 min of ischaemia, followed by 5 min of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 h postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria). Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p = 0.023)—there was a decrease (− 0.007 µmol/L, ± 0.020 µmol/L, p = 0.0233) in the RIPC group and increase (0.002 µmol/L, ± 0.015 µmol/L, p = 0.481) in the sham group. Additionally, a decrease from baseline to 24 h after surgery (p < 0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was an increase (p < 0.05) in the levels of C0 (carnitine) and a decrease in the level of C18:1-OH. In the RIPC group, a decrease (p < 0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2. It can be concluded that RIPC may have an effect on the levels of ACs and might therefore have protective effects on mitochondria in the vascular surgery patients. Further larger studies conducted on homogenous populations are needed to make more definite conclusions about the effect of RIPC on the metabolism of ACs. ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414 .

中文翻译：

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远程缺血预处理影响血管手术中酰基肉碱的水平：一项随机临床试验。

血管手术患者组织的血液供应减少，这可能导致线粒体功能障碍和酰基肉碱（ACs）的积累。有人提出远程缺血预处理（RIPC）通过促进线粒体功能发挥其器官保护作用。本研究的目的是评估 RIPC 对血管手术患者 ACs 谱的影响。这是一项随机、假对照、双盲、单中心研究。非连续招募接受腹主动脉瘤开放手术修复、下肢血运重建手术或颈动脉内膜切除术的患者。应用 RIPC 方案，包括 4 个循环，即 5 分钟缺血，然后再灌注 5 分钟。血压袖带用于 RIPC 或假手术。术前和术后约 24 小时采血。使用 AbsoluteIDQp180 试剂盒（Biocrates Life Sciences AG，​​Innsbruck，Austria）分析 ACs 的概况。98 名患者被招募并随机分配到研究组中，RIPC 组的 45 名患者和假手术组的 47 名患者被纳入最终分析。在 C3-OH 的变化方面，各组之间存在统计学显着差异（p = 0.023）——RIPC 组减少（- 0.007 µmol/L，± 0.020 µmol/L，p = 0.0233），增加（ 0.002 µmol/L, ± 0.015 µmol/L, p = 0.481) 在假手术组中。此外，在假手术组和 RIPC 组中检测到以下 AC 水平从基线到术后 24 小时下降（p < 0.05）：C2、C8、C10、C10:1、C12、C12:1、C14 ：1，C14：2，C16，C16：1，C18，C18：1，C18：2。在假手术组中，C0（肉碱）水平升高（p < 0.05），C18:1-OH 水平降低。在 RIPC 组中，C3-OH、C3-DC (C4-OH)、C6:1、C9、C10:2 的水平下降 (p < 0.05)。可以得出结论，RIPC 可能对 ACs 水平有影响，因此可能对血管手术患者的线粒体具有保护作用。需要对同质人群进行更大规模的研究，以对 RIPC 对 ACs 代谢的影响做出更明确的结论。ClinicalTrials.gov 数据库，NCT02689414。2016 年 2 月 24 日注册——追溯注册，https://clinicaltrials.gov/ct2/show/NCT02689414。在 RIPC 组中，C3-OH、C3-DC (C4-OH)、C6:1、C9、C10:2 的水平下降 (p < 0.05)。可以得出结论，RIPC 可能对 ACs 水平有影响，因此可能对血管手术患者的线粒体具有保护作用。需要对同质人群进行更大规模的研究，以对 RIPC 对 ACs 代谢的影响做出更明确的结论。ClinicalTrials.gov 数据库，NCT02689414。2016 年 2 月 24 日注册——追溯注册，https://clinicaltrials.gov/ct2/show/NCT02689414。在 RIPC 组中，C3-OH、C3-DC (C4-OH)、C6:1、C9、C10:2 的水平下降 (p < 0.05)。可以得出结论，RIPC 可能对 ACs 水平有影响，因此可能对血管手术患者的线粒体具有保护作用。需要对同质人群进行更大规模的研究，以对 RIPC 对 ACs 代谢的影响做出更明确的结论。ClinicalTrials.gov 数据库，NCT02689414。2016 年 2 月 24 日注册——追溯注册，https://clinicaltrials.gov/ct2/show/NCT02689414。需要对同质人群进行更大规模的研究，以对 RIPC 对 ACs 代谢的影响做出更明确的结论。ClinicalTrials.gov 数据库，NCT02689414。2016 年 2 月 24 日注册——追溯注册，https://clinicaltrials.gov/ct2/show/NCT02689414。需要对同质人群进行更大规模的研究，以对 RIPC 对 ACs 代谢的影响做出更明确的结论。ClinicalTrials.gov 数据库，NCT02689414。2016 年 2 月 24 日注册——追溯注册，https://clinicaltrials.gov/ct2/show/NCT02689414。