Plasma trimethylamine N-oxide is associated with vulnerable plaque characteristics in CAD patients as assessed by optical coherence tomography

Liu, Xinxin; Xie, Zulong; Sun, Meng; Wang, Xuedong; Ji, Li Li; Cui, Jinjin; Zhang, Fengyun; Yin, Li; Huang, Dan; Hou, Jingbo; Tian, Jing; Yu, Bo

doi:10.1016/j.ijcard.2018.04.126

Cited by 48 publications

(32 citation statements)

References 31 publications

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“…A total of 37 records were retrieved for more detailed evaluations, and 12 clinical studies were included in our meta‐analysis (Figure ), including eight cohort studies, two case‐control studies, and two cross‐sectional studies . We used nine articles for the meta‐analysis of two‐class variables and five articles for the meta‐analysis of continuous variables based on the original data. Notably, only five articles were applied for dose‐response analyses after screening.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies, including five cohort studies, two case‐control studies, and two cross‐sectional studies, with a total of 12 961 participants, were applied in the two‐class meta‐analysis. In these original studies, the authors provided the queues grouped according to the level of TMAO and provided the number of patients with DM in different groups, so as the number of non‐DM.…”

Section: Resultsmentioning

confidence: 99%

“…The results should be interpreted with caution and considered hypothesis generating. Second, the original studies included are all observational study, including eight cohort studies, two case‐control studies, and two cross‐sectional studies . Third, we did not take full account of the duration of diabetes in the population, and we cannot exclude the effect of duration of DM on circulating TMAO levels.…”

Section: Limitationsmentioning

confidence: 99%

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Gut microbe–generated metabolite trimethylamine N‐oxide and the risk of diabetes: A systematic review and dose‐response meta‐analysis

et al. 2019

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Elevated circulating concentrations of the gut bacteria choline metabolite trimethylamine N-oxide (TMAO) were found in patients with type 2 diabetes mellitus (T2DM). However, whether a high level of TMAO is related to the risk of diabetes has not been studied. We aimed to synthesize the evidence on the relation between TMAO levels and the risk of diabetes mellitus (DM) and to investigate the association further in a dose-response meta-analysis. PubMed, Web of Science, and Scopus databases were searched for studies from inception to June 2018. A total of 12 clinical studies were included in this study, and 15 314 enrolled subjects were included. A meta-analysis of two-class variables and continuous variables were used to obtain pooled effects. Dose-response meta-analysis was used to investigate the dose-response relationship between TMAO concentrations and the risk of DM.Meta-regression and subgroup analyses were applied to identify the source of heterogeneity in this study. High levels of circulating TMAO were associated with an increased risk of DM (odds ratio [OR] = 1.89) using the two-class meta-analysis.Plasma levels of TMAO in patients with diabetes were higher than in subjects without diabetes (standardized mean difference [SMD]: 0.36) using a meta-analysis of continuous variables. The OR for DM prevalence increased by 54% per 5 μmol L −1 increment of plasma TMAO (OR = 1.54) according to the dose-response metaanalysis. This is the first systematic review and meta-analysis to demonstrate a positive dose-dependent association between circulating TMAO levels and increased diabetes risk.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Gut microbe–generated metabolite trimethylamine N‐oxide and the risk of diabetes: A systematic review and dose‐response meta‐analysis

et al. 2019

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“…In a cross‐sectional study among 1286 Canadians, the highest quintile of serum TMAO was associated with increased prevalent CVD after adjustment for potential confounders (OR, 9.33; CI, 1.88‐46.37; P = .006). Increased carotid intima‐media thickness in higher TMAO concentrations was also reported by Randrianarisoa et al Several other studies also reported an association between TMAO and stroke in hypertensive adults, an association with vulnerable plaque characteristics in coronary artery disease (CAD) patients, and a higher mortality risk among patients with type 2 diabetes mellitus (T 2 DM) independent of glycemic status . Most of these studies focused on the association between TMAO and CVD, diabetes, or major advanced cardiac events (MACE) and obesity or body mass index (BMI) were investigated as secondary or even tertiary outcomes in these studies.…”

Section: Introductionmentioning

confidence: 81%

Gut microbiota‐derived metabolite trimethylamine N‐oxide (TMAO) potentially increases the risk of obesity in adults: An exploratory systematic review and dose‐response meta‐ analysis

et al. 2020

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Summary It has been suggested that trimethylamine N‐oxide (TMAO) is associated with increased risk of diabetes and cardiovascular disease (CVD) morbidity and mortality. However, it is not known whether increased TMAO concentrations is associated with obesity. In the current study, we summarized the evidence related to the association of circulating TMAO with the risk of obesity measurements, including body mass index (BMI), waist circumference (WC), and waist‐to‐hip ratio (WHR) in a two‐class and dose‐response meta‐analysis of observational studies. A systematic search carried out in PubMed, SCOPUS, Cochrane, and ProQuest through September 30, 2019 resulted in 12 eligible studies which were included in the current meta‐synthesis. In these studies, BMI was reported but there were no reports of WC or WHR. Meta‐analysis of two‐class variables and dose‐response meta‐analysis of continuous variables were performed. Subgroup analysis and meta‐regression were also performed to identify the source of heterogeneity. There was a dose‐response association between circulating TMAO concentration and increased BMI in studies involving healthy individuals (P nonlinearity = .007), while no evidence of departure from linearity was observed according to study design or among patients with CVD. Results showed the highest category of TMAO was associated with 0.56 kg/m2 increase in BMI (weighted mean difference [WMD], 0.563; CI, 0.026‐1.100; P = .04). The results of the current meta‐analysis revealed a positive association between circulating TMAO and obesity as presented by increased BMI. Moreover, a dose‐dependent association between circulating TMAO and obesity was also identified in apparently healthy individuals. This is the first meta‐analysis to reveal positive dose‐dependent associations between circulating TMAO concentration and obesity.

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“…All subjects were divided into a high‐TMAO group and a low‐TMAO group, and plaques in the high‐TMAO group exhibited lower fibrous cap thickness and higher incidence of TCFA. TMAO levels were significantly associated with the high prevalence of TCFA, with relatively high specificity and sensitivity in predicting the incidence of TCFA ().…”

Section: Plaque Instabilitymentioning

confidence: 99%

Gut microbiota in atherosclerosis: focus on trimethylamine N‐oxide

Zhu

Jiang

2020

APMIS

100

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in atherosclerosis: focus on trimethylamine N-oxide. APMIS 2020; 128: 353-366.The increasing prevalence of cardiovascular diseases cannot adequately be explained by traditional risk factors. Recently, accumulating evidence has suggested that gut microbiota-derived numerous metabolites are contributors to atherosclerotic events. Among them, the role of trimethylamine N-oxide (TMAO) in promoting atherosclerosis has gained attention. TMAO is reported to exert the proatherogenic effects by impacting on the traditional risk factors of atherosclerosis and is associated with high risk of cardiovascular events. Besides that, TMAO is involved in the complex pathological processes of atherosclerotic lesion formation, such as endothelial dysfunction, platelet activation and thrombus generation. In light of these promising findings, TMAO may serve as a potential target for atherosclerosis prevention and treatment, which is conceptually novel, when compared with existing traditional treatments. It is likely that regulating TMAO production and associated gut microbiota may become a promising strategy for the anti-atherosclerosis therapy.

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Plasma trimethylamine N-oxide is associated with vulnerable plaque characteristics in CAD patients as assessed by optical coherence tomography

Cited by 48 publications

References 31 publications

Gut microbe–generated metabolite trimethylamine N‐oxide and the risk of diabetes: A systematic review and dose‐response meta‐analysis

Gut microbe–generated metabolite trimethylamine N‐oxide and the risk of diabetes: A systematic review and dose‐response meta‐analysis

Gut microbiota‐derived metabolite trimethylamine N‐oxide (TMAO) potentially increases the risk of obesity in adults: An exploratory systematic review and dose‐response meta‐ analysis

Gut microbiota in atherosclerosis: focus on trimethylamine N‐oxide

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