Urinary Excretion of Sulfur Metabolites and Risk of Cardiovascular Events and All-Cause Mortality in the General Population

Joost van den Born, Anne-Roos Frenay, Anne M Koning, Matthias Bachtler, Ineke Riphagen, Isidor Minovic, Martin Feelisch, Marinda Dekker, Marian Bulthuis, Ron Gansevoort, Jan-Luuk Hillebrands, Andreas Pasch, Stephan Bakker, Harry van Goor*

*Corresponding author for this work

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Abstract

Aims: Thiosulfate and sulfate are metabolites of hydrogen sulfide (H2S), a gaseous signaling molecule with cardiovascular (CV) protective properties. Urinary thiosulfate excretion and sulfate excretion are associated with favorable disease outcome in high-risk patient groups. We investigated the relationship between urinary excretion of sulfur metabolites, and risk of CV events and all-cause mortality in the general population.

Results: Subjects (n = 6839) of the Prevention of Renal and Vascular End-stage Disease (PREVEND) study were followed prospectively. At baseline, 24-h urinary excretion of thiosulfate and sulfate was determined. Median urinary thiosulfate and sulfate excretion values were 1.27 (interquartile range [IQR] 0.89-2.37) mol/24h and 15.7 (IQR 12.0-20.3) mmol/24h, respectively. Neither thiosulfate nor sulfate excretion showed an independent association with risk of CV events. Sulfate, but not thiosulfate, was inversely associated with risk of all-cause mortality, independent of potential confounders (hazard ratio 0.73 [95% confidence interval 0.63-0.84], p

Innovation: The strong association between sulfate excretion and mortality in the general population emphasizes the (patho)physiological importance of sulfate or its precursor H2S.

Conclusion: We hypothesize that urinary sulfate excretion, which is inversely associated with all-cause mortality in the general population, holds clinical relevance as a beneficial modulator in health and disease.

Original languageEnglish
Pages (from-to)1999-2010
Number of pages12
JournalAntioxidants & Redox Signaling
Volume30
Issue number17
DOIs
Publication statusPublished - 23-Apr-2019

Keywords

  • epidemiology
  • cardiovascular events
  • mortality
  • sulfate
  • thiosulfate
  • hydrogen sulfide
  • METHIONINE-SUPPLEMENTED DIET
  • GLOMERULAR-FILTRATION-RATE
  • HYDROGEN-SULFIDE
  • BLOOD-PRESSURE
  • AMINO-ACIDS
  • HYPERTENSIVE-RATS
  • HEART-FAILURE
  • RENAL-DISEASE
  • SULFATE
  • THIOSULFATE

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