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Salamat S, Jahan-Mihan A, Tabandeh MR, Mansoori A. Randomized clinical trial evaluating the efficacy of synbiotic supplementation on serum endotoxin and trimethylamine N-oxide levels in patients with dyslipidaemia. Arch Med Sci Atheroscler Dis 2024; 9:e18-e25. [PMID: 38434939 PMCID: PMC10905263 DOI: 10.5114/amsad/178106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/01/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Elevated serum endotoxin and trimethylamine N-oxide (TMAO) are associated with metabolic disorders including dyslipidaemia and insulin resistance. This study aimed to evaluate the impact of a 12-week treatment with a synbiotic supplement on serum endotoxin and TMAO levels in patients diagnosed with dyslipidaemia. Material and methods A total of 56 patients who met the study inclusion criteria were recruited in this randomized, double-blind clinical trial. Participants were randomly assigned into intervention and control groups and received either synbiotic or placebo sachets twice a day for 12 weeks. The sociodemographic data, food intake, physical activity, and anthropometric indices of participants were assessed before and after intervention. Serum endotoxin, TMAO, and fasting blood glucose (FBG) levels were measured at the baseline and end of the study. Results No significant difference in the baseline characteristics of participants in the 2 groups was observed. After the 12 weeks of intervention, the mean of serum endotoxin (p < 0.0001), TMAO (p < 0.0001), and FBG (p < 0.0001) was decreased in patients who received synbiotic supplements while no significant change was observed in the control group. Moreover, a significant positive correlation between changes in endotoxin (r = 0.41, p = 0.041) and TMAO (r = 0.40, p = 0.047) with FBG changes was observed. Conclusions A significant reduction in serum endotoxin and TMAO levels, as well as improvements in FBG, following 12 weeks of supplementation with synbiotics, may offer a potential approach for improving metabolic status in patients with dyslipidaemia.
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Affiliation(s)
- Shekoufeh Salamat
- Nutrition and Metabolic Diseases Research Centre, Clinical Sciences Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Jahan-Mihan
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL, USA
| | - Mohammad Reza Tabandeh
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
- Stem Cells and Transgenic Technology Research Center, Shahid Chamran University of Ahvaz, Iran
| | - Anahita Mansoori
- Nutrition and Metabolic Diseases Research Centre, Clinical Sciences Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Han JM, Guo L, Chen XH, Xie Q, Song XY, Ma YL. Relationship between trimethylamine N-oxide and the risk of hypertension in patients with cardiovascular disease: A meta-analysis and dose-response relationship analysis. Medicine (Baltimore) 2024; 103:e36784. [PMID: 38181288 PMCID: PMC10766215 DOI: 10.1097/md.0000000000036784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/26/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND The gut microbiota-dependent metabolite trimethylamine N-oxide (TMAO) has recently been recognized to be one of the risk factors for cardiovascular disease (CVD). However, there is a scarcity of data on the relationship between circulating TMAO levels and hypertension in patients with CVD. Meta analysis and a dose-response relationship were used in this study to assess the relationship between circulating trimethylamine N-oxide levels and the risk of hypertension in patients with CVD. METHODS CNKI, Wanfang Database, Pubmed, Embase, Cochrane Library, and Web of Science were searched up to June 01, 2023. Meta-analysis and dose-response analysis of relative risk data from prospective cohort studies reporting on the relationship between circulating TMAO levels and hypertension risk in patients with CVD were conducted. RESULTS Fifteen studies with a total of 15,498 patients were included in the present meta-analysis. Compared with a lower circulating TMAO level, a higher TMAO level was associated with a higher risk of hypertension in patients with CVD (RR = 1.14,95%CI (1.08, 1.20)). And the higher the TMAO level, the greater the risk of hypertension. The dose-response analysis revealed a linear dose-response relationship between circulating TMAO levels and the risk of hypertension in patients with CVD. The risk of hypertension increased by 1.014% when the circulating TMAO level increased by 1 μ mol/L. CONCLUSION In patients with CVD, the level of circulating TMAO is significantly related to the risk of hypertension. The risk of hypertension increased by 1.014% for every 1 μ mol/L increase in circulating TMAO levels.
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Affiliation(s)
- Jia-Ming Han
- Medical College of Qinghai University, Xining, China
| | - Lu Guo
- Medical College of Qinghai University, Xining, China
| | - Xian-Hui Chen
- Medical College of Qinghai University, Xining, China
| | - Qian Xie
- Medical College of Qinghai University, Xining, China
| | - Xiu-Ying Song
- Medical College of Qinghai University, Xining, China
| | - Yu-Lan Ma
- Department of Cardiology, Affiliated Hospital of Qinghai University, Xining, China
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Gungor O, Hasbal NB, Alaygut D. Trimethylamine N-oxide and kidney diseases: what do we know? J Bras Nefrol 2024; 46:85-92. [PMID: 38039494 PMCID: PMC10962421 DOI: 10.1590/2175-8239-jbn-2023-0065en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/13/2023] [Indexed: 12/03/2023] Open
Abstract
In the human gut, there is a metabolically active microbiome whose metabolic products reach various organs and are used in the physiological activities of the body. When dysbiosis of intestinal microbial homeostasis occurs, pathogenic metabolites may increase and one of them is trimethyl amine-N-oxide (TMAO). TMAO is thought to have a role in the pathogenesis of insulin resistance, diabetes, hyperlipidemia, atherosclerotic heart diseases, and cerebrovascular events. TMAO level is also associated with renal inflammation, fibrosis, acute kidney injury, diabetic kidney disease, and chronic kidney disease. In this review, the effect of TMAO on various kidney diseases is discussed.
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Affiliation(s)
- Ozkan Gungor
- Kahramanmaras Sutcu Imam University, School of Medicine, Department
of Internal Medicine, Kahramanmaras, Turkey
| | - Nuri Baris Hasbal
- Koc University, School of Medicine, Department of Internal Medicine,
Istanbul, Turkey
| | - Demet Alaygut
- Izmir Katip Celebi University, School of Medicine, Department of
Pediatrics, Izmir, Turkey
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Banno Y, Nomura M, Hara R, Asami M, Tanaka K, Mukai Y, Tomata Y. Trimethylamine N-oxide and risk of inflammatory bowel disease: A Mendelian randomization study. Medicine (Baltimore) 2023; 102:e34758. [PMID: 37653747 PMCID: PMC10470767 DOI: 10.1097/md.0000000000034758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
A previous study suggested that inflammatory bowel disease (IBD) patients have low plasma levels of trimethylamine N-oxide (TMAO). In the present study, we examined this hypothesis using Mendelian randomization analysis. We used summary statistics data for single-nucleotide polymorphisms associated with plasma levels of TMAO, and the corresponding data for IBD from a genome-wide association meta-analysis of 59,957 individuals (25,042 diagnosed IBD cases, 34,915 controls). The association between genetically predicted plasma TMAO levels and IBD showed odds ratios (95% confidence interval [CI]) per 1 interquartile range increment (per 2.4 μmol/L) in TMAO levels were 0.91 (0.81-1.01, P = .084) for IBD, 0.88 (0.76-1.02, P = .089) for ulcerative colitis, 0.91 (0.79-1.05, P = .210) for Crohn disease. There was no evidence for pleiotropy based on the Mendelian randomization-Egger regression analyses (P-intercept = 0.669 for IBD). Further investigations would be needed to understand the causal relationship between TMAO and IBD.
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Affiliation(s)
- Yukika Banno
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Miho Nomura
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Risako Hara
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Momoko Asami
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Kotone Tanaka
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Yuuka Mukai
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Yasutake Tomata
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
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James KL, Gertz ER, Cervantes E, Bonnel EL, Stephensen CB, Kable ME, Bennett BJ. Diet, Fecal Microbiome, and Trimethylamine N-Oxide in a Cohort of Metabolically Healthy United States Adults. Nutrients 2022; 14. [PMID: 35405993 DOI: 10.3390/nu14071376] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/08/2023] Open
Abstract
TMAO is elevated in individuals with cardiometabolic diseases, but it is unknown whether the metabolite is a biomarker of concern in healthy individuals. We conducted a cross-sectional study in metabolically healthy adults aged 18-66 years with BMI 18-44 kg/m2 and assessed the relationship between TMAO and diet, the fecal microbiome, and cardiometabolic risk factors. TMAO was measured in fasted plasma samples by liquid chromatography mass spectrometry. The fecal microbiome was assessed by 16S ribosomal RNA sequencing and recent food intake was captured by multiple ASA24 dietary recalls. Endothelial function was assessed via EndoPAT. Descriptive statistics were computed by fasting plasma TMAO tertiles and evaluated by ANOVA and Tukey's post-hoc test. Multiple linear regression was used to assess the relationship between plasma TMAO and dietary food intake and metabolic health parameters. TMAO concentrations were not associated with average intake of animal protein foods, fruits, vegetables, dairy, or grains. TMAO was related to the fecal microbiome and the genera Butyribrio, Roseburia, Coprobaciullus, and Catenibacterium were enriched in individuals in the lowest versus the highest TMAO tertile. TMAO was positively associated with α-diversity and compositional differences were identified between groups. TMAO was not associated with classic cardiovascular risk factors in the healthy cohort. Similarly, endothelial function was not related to fasting TMAO, whereas the inflammatory marker TNF-α was significantly associated. Fasting plasma TMAO may not be a metabolite of concern in generally healthy adults unmedicated for chronic disease. Prospective studies in healthy individuals are necessary.
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Abstract
Alzheimer's disease (AD) is a neurodegenerative disease that affects memory and cognitive function. Clinical evidence has put into question our current understanding of AD development, propelling researchers to look into further avenues. Gut microbiota has emerged as a potential player in AD pathophysiology. Lifestyle factors, such as diet, can have negative effects on the gut microbiota and thus host health. A Western-type diet has been highlighted as a risk factor for both gut microbiota alteration as well as AD development. The gut-derived trimethylamine N-oxide (TMAO) has been previously implied in the development of cardiovascular diseases with recent evidence suggesting a plausible role of TMAO in AD development. Therefore, the main goal of the present review is to provide the reader with potential mechanisms of action through which consumption of a Western-type diet could increase AD risk, by acting through microbiota-produced TMAO. Although a link between TMAO and AD is far from definitive, this review will serve as a call for research into this new area of research.
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Affiliation(s)
- Pablo Arrona Cardoza
- P. Arrona Cardoza is with the Tecnológico de Monterrey, School of Medicine and Health Science, Monterrey, Nuevo Leon, Mexico. M.B Spillane is with the H.C. Drew School of Health and Human Performance, McNeese State University, Lake Charles, Louisiana, USA. E. Morales Marroquin is with the School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA. E. Morales Marroquin is with the Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas, USA
| | - Micheil B Spillane
- P. Arrona Cardoza is with the Tecnológico de Monterrey, School of Medicine and Health Science, Monterrey, Nuevo Leon, Mexico. M.B Spillane is with the H.C. Drew School of Health and Human Performance, McNeese State University, Lake Charles, Louisiana, USA. E. Morales Marroquin is with the School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA. E. Morales Marroquin is with the Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas, USA
| | - Elisa Morales Marroquin
- P. Arrona Cardoza is with the Tecnológico de Monterrey, School of Medicine and Health Science, Monterrey, Nuevo Leon, Mexico. M.B Spillane is with the H.C. Drew School of Health and Human Performance, McNeese State University, Lake Charles, Louisiana, USA. E. Morales Marroquin is with the School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA. E. Morales Marroquin is with the Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas, USA
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Camelo-Castillo A, Rivera-Caravaca JM, Orenes-Piñero E, Ramírez-Macías I, Roldán V, Lip GYH, Marín F. Gut Microbiota and the Quality of Oral Anticoagulation in Vitamin K Antagonists Users: A Review of Potential Implications. J Clin Med 2021; 10:715. [PMID: 33670220 PMCID: PMC7916955 DOI: 10.3390/jcm10040715] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 12/31/2022] Open
Abstract
The efficacy and safety of vitamin K antagonists (VKAs) as oral anticoagulants (OACs) depend on the quality of anticoagulation control, as reflected by the mean time in therapeutic range (TTR). Several factors may be involved in poor TTR such as comorbidities, high inter-individual variability, interacting drugs, and non-adherence. Recent studies suggest that gut microbiota (GM) plays an important role in the pathogenesis of cardiovascular diseases, but the effect of the GM on anticoagulation control with VKAs is unknown. In the present review article, we propose different mechanisms by which the GM could have an impact on the quality of anticoagulation control in patients taking VKA therapy. We suggest that the potential effects of GM may be mediated first, by an indirect effect of metabolites produced by GM in the availability of VKAs drugs; second, by an effect of vitamin K-producing bacteria; and finally, by the structural modification of the molecules of VKAs. Future research will help confirm these hypotheses and may suggest profiles of bacterial signatures or microbial metabolites, to be used as biomarkers to predict the quality of anticoagulation. This could lead to the design of intervention strategies modulating gut microbiota, for example, by using probiotics.
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Affiliation(s)
- Anny Camelo-Castillo
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain; (A.C.-C.); (J.M.R.-C.); (I.R.-M.)
| | - José Miguel Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain; (A.C.-C.); (J.M.R.-C.); (I.R.-M.)
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L7 8TX, UK;
| | - Esteban Orenes-Piñero
- Department of Biochemistry and Molecular Biology-A, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain;
| | - Inmaculada Ramírez-Macías
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain; (A.C.-C.); (J.M.R.-C.); (I.R.-M.)
| | - Vanessa Roldán
- Department of Hematology and Clinical Oncology, Hospital General Universitario Morales Meseguer, University of Murcia, 30008 Murcia, Spain;
| | - Gregory Y. H. Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L7 8TX, UK;
- Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, 9000 Aalborg, Denmark
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, 30120 Murcia, Spain; (A.C.-C.); (J.M.R.-C.); (I.R.-M.)
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Diallo AF, Lockwood MB, Maki KA, Franks AT, Roy A, Jaime-Lara R, Joseph PV, Henderson WA, Chung SY, McGrath J, Green SJ, Fink AM. Metabolic Profiling of Blood and Urine for Exploring the Functional Role of the Microbiota in Human Health. Biol Res Nurs 2020; 22:449-457. [PMID: 32723087 DOI: 10.1177/1099800420941080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The quantification of metabolites in blood and urine allows nurses to explore new hypotheses about the microbiome. This review summarizes findings from recent studies with a focus on how the state of the science can influence future nursing research initiatives. Metabolomics can advance nursing research by identifying physiologic/pathophysiologic processes underlying patients' symptoms and can be useful for testing the effects of nursing interventions. To date, metabolomics has been used to study cardiovascular, respiratory, endocrine, autoimmune, and infectious conditions, with research focused on understanding the microbial metabolism of substrates resulting in circulating/excreted biomarkers such as trimethylamine N-oxide. This review provides specific recommendations for the collection of specimens and goals for future studies.
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Affiliation(s)
- Ana F Diallo
- Institute of Inclusion, Inquiry & Innovation (iCubed), Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Mark B Lockwood
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Katherine A Maki
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Alexis T Franks
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, 2511National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Abhrarup Roy
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, 2511National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Rosario Jaime-Lara
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, 2511National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Paule V Joseph
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, 2511National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Wendy A Henderson
- Digestive Disorders Unit, Biobehavioral Branch, Division of Intramural Research, 2511National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Seon Yoon Chung
- School of Nursing, University of Maryland, Baltimore, MD, USA
| | - Jacqueline McGrath
- School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
| | - Stefan J Green
- Sequencing Core, Research Resources Center, 14681University of Illinois at Chicago, Chicago, IL, USA
| | - Anne M Fink
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Bin Waleed K, Lu Y, Liu Q, Zeng F, Tu H, Wei Y, Xu S, Zhang Z, Rongfeng Y, Fan A, Altaf A, Chang J, Wang L. Association of trimethylamine N-oxide with coronary atherosclerotic burden in patients with non-ST-segment elevation myocardial infarction. Medicine (Baltimore) 2020; 99:e20794. [PMID: 32629663 PMCID: PMC7337475 DOI: 10.1097/md.0000000000020794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Recently, trimethylamine N-oxide (TMAO) unexplained gut microbe has been proposed as a promising risk factor for atherosclerotic cardiovascular disease (CVD) pathogenesis and adverse events. The relationship of TMAO with coronary atherosclerotic burden has been evaluated in patients with stable coronary artery disease and ST-segment elevation myocardial infarction, but still needs to be explored in newly diagnosed non-ST-segment elevation myocardial infarction (NSTEMI) patients. MATERIAL AND METHODS A prospective, single-center, SZ-NSTEMI trial (ChiCTR1900022366) is underway to investigate the relationship of TMAO with the severity and prognosis of coronary atherosclerosis in newly diagnosed NSTEMI patients who will undergo coronary angiography with primary percutaneous coronary intervention (pPCI). The primary endpoint of the study will be assessed the association of TMAO with coronary atherosclerotic severity quantify by the number of diseased coronary arteries and SYNTAX score after the coronary angiography. The secondary endpoints will be identified the TMAO as a prognostic biomarker for the short (1 month) and long-term (12 months) major cardiovascular and cerebrovascular events (MACCEs) rate including myocardial infarction, target vessel revascularization, stroke, heart failure, all-cause rehospitalization, and all-cause mortality after the pPCI. The blood samples will be collected from each patient before the procedure to measure the TMAO by isotope dilution high-performance liquid chromatography. In conclusion, SZ-NSTEMI will be the first cohort that will be investigated the association of TMAO with the severity and prognosis of coronary atherosclerotic burden in NSTEMI patients, aiming to identify TMAO as a predictor and a prognostic biomarker.
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Affiliation(s)
- Khalid Bin Waleed
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
- Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yongkang Lu
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Qiang Liu
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Fanfang Zeng
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Hong Tu
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Yi Wei
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Shuai Xu
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Zhiling Zhang
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Yang Rongfeng
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Ailing Fan
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
| | - Afrasyab Altaf
- Department of Cardiology, Rehman Medical Institute, Peshawar, Pakistan
| | - Junlei Chang
- Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lili Wang
- Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen
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Dalla Via A, Gargari G, Taverniti V, Rondini G, Velardi I, Gambaro V, Visconti GL, De Vitis V, Gardana C, Ragg E, Pinto A, Riso P, Guglielmetti S. Urinary TMAO Levels Are Associated with the Taxonomic Composition of the Gut Microbiota and with the Choline TMA-Lyase Gene ( cutC) Harbored by Enterobacteriaceae. Nutrients 2019; 12:E62. [PMID: 31881690 DOI: 10.3390/nu12010062] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 12/19/2019] [Indexed: 12/26/2022] Open
Abstract
Gut microbiota metabolization of dietary choline may promote atherosclerosis through trimethylamine (TMA), which is rapidly absorbed and converted in the liver to proatherogenic trimethylamine-N-oxide (TMAO). The aim of this study was to verify whether TMAO urinary levels may be associated with the fecal relative abundance of specific bacterial taxa and the bacterial choline TMA-lyase gene cutC. The analysis of sequences available in GenBank grouped the cutC gene into two main clusters, cut-Dd and cut-Kp. A quantitative real-time polymerase chain reaction (qPCR) protocol was developed to quantify cutC and was used with DNA isolated from three fecal samples collected weekly over the course of three consecutive weeks from 16 healthy adults. The same DNA was used for 16S rRNA gene profiling. Concomitantly, urine was used to quantify TMAO by ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS). All samples were positive for cutC and TMAO. Correlation analysis showed that the cut-Kp gene cluster was significantly associated with Enterobacteriaceae. Linear mixed models revealed that urinary TMAO levels may be predicted by fecal cut-Kp and by 23 operational taxonomic units (OTUs). Most of the OTUs significantly associated with TMAO were also significantly associated with cut-Kp, confirming the possible relationship between these two factors. In conclusion, this preliminary method-development study suggests the existence of a relationship between TMAO excreted in urine, specific fecal bacterial OTUs, and a cutC subgroup ascribable to the choline-TMA conversion enzymes of Enterobacteriaceae.
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11
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Wu WK, Chen CC, Liu PY, Panyod S, Liao BY, Chen PC, Kao HL, Kuo HC, Kuo CH, Chiu THT, Chen RA, Chuang HL, Huang YT, Zou HB, Hsu CC, Chang TY, Lin CL, Ho CT, Yu HT, Sheen LY, Wu MS. Identification of TMAO-producer phenotype and host-diet-gut dysbiosis by carnitine challenge test in human and germ-free mice. Gut 2019; 68:1439-1449. [PMID: 30377191 PMCID: PMC6691853 DOI: 10.1136/gutjnl-2018-317155] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/08/2018] [Accepted: 10/11/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The gut microbiota-derived metabolite, trimethylamine N-oxide (TMAO) plays an important role in cardiovascular disease (CVD). The fasting plasma TMAO was shown as a prognostic indicator of CVD incident in patients and raised the interest of intervention targeting gut microbiota. Here we develop a clinically applicable method called oral carnitine challenge test (OCCT) for TMAO-related therapeutic drug efforts assessment and personalising dietary guidance. DESIGN A pharmacokinetic study was performed to verify the design of OCCT protocol. The OCCT was conducted in 23 vegetarians and 34 omnivores to validate gut microbiota TMAO production capacity. The OCCT survey was integrated with gut microbiome, host genotypes, dietary records and serum biochemistry. A humanised gnotobiotic mice study was performed for translational validation. RESULTS The OCCT showed better efficacy than fasting plasma TMAO to identify TMAO producer phenotype. The omnivores exhibited a 10-fold higher OR to be high TMAO producer than vegetarians. The TMAO-associated taxa found by OCCT in this study were consistent with previous animal studies. The TMAO producer phenotypes were also reproduced in humanised gnotobiotic mice model. Besides, we found the faecal CntA gene was not associated with TMAO production; therefore, other key relevant microbial genes might be involved. Finally, we demonstrated the urine TMAO exhibited a strong positive correlation with plasma TMAO (r=0.92, p<0.0001) and improved the feasibility of OCCT. CONCLUSION The OCCT can be used to identify TMAO-producer phenotype of gut microbiota and may serve as a personal guidance in CVD prevention and treatment. TRIAL REGISTRATION NUMBER NCT02838732; Results.
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Affiliation(s)
- Wei-Kai Wu
- Department of Internal Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan,Institute of Food Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Chieh-Chang Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Yu Liu
- Department of Life Science, National Taiwan University, Taipei, Taiwan,Genome and Systems Biology Degree Program, Academia Sinica, Taipei, Taiwan
| | - Suraphan Panyod
- Institute of Food Science and Technology, National Taiwan University, Taipei, Taiwan,Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ben-Yang Liao
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Pei-Chen Chen
- Institute of Food Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Hsien-Li Kao
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Chun Kuo
- The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Hua Kuo
- The Metabolomics Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan,School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tina H T Chiu
- Department of Nutrition Therapy, Dalin Tzu Chi Hospital, Chiayi, Taiwan
| | - Rou-An Chen
- Institute of Food Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Hsiao-Li Chuang
- National Applied Research Laboratories, National Laboratory Animal Center, Taipei, Taiwan
| | - Yen-Te Huang
- National Applied Research Laboratories, National Laboratory Animal Center, Taipei, Taiwan
| | - Hsin-Bai Zou
- Department of Chemistry, National Taiwan University, Taipei, Taiwan
| | - Cheng-Chih Hsu
- Department of Chemistry, National Taiwan University, Taipei, Taiwan
| | - Ting-Yan Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Chin-Lon Lin
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Taipei, Taiwan
| | - Chi-Tang Ho
- Department of Food Science, Rutgers University, New Burnswick, New Jersey, USA
| | - Hon-Tsen Yu
- Department of Life Science, National Taiwan University, Taipei, Taiwan,Genome and Systems Biology Degree Program, Academia Sinica, Taipei, Taiwan
| | - Lee-Yan Sheen
- Institute of Food Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan,Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Tindall AM, Petersen KS, Kris-Etherton PM. Dietary Patterns Affect the Gut Microbiome-The Link to Risk of Cardiometabolic Diseases. J Nutr 2018; 148:1402-1407. [PMID: 30184227 PMCID: PMC7263841 DOI: 10.1093/jn/nxy141] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/25/2018] [Accepted: 06/15/2018] [Indexed: 12/21/2022] Open
Abstract
Clusters of bacterial species within the gut microenvironment, or gut enterotype, have been correlated with cardiometabolic disease risk. The metabolic products and metabolites that bacteria produce, such as short-chain fatty acids, secondary bile acids, and trimethylamine, may also affect the microbial community and disease risk. Diet has a direct impact on the gut microenvironment by providing substrates to and promoting the colonization of resident bacteria. To date, few dietary patterns have been evaluated for their effect on the gut microbiome, but the Mediterranean diet and Vegetarian diets have shown favorable effects for both the gut microbiome and cardiometabolic disease risk. This review examines the gut microbiome as a mediator between these dietary patterns and cardiometabolic disease risk.
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Affiliation(s)
- Alyssa M Tindall
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Kristina S Petersen
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
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13
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Stroup BM, Nair N, Murali SG, Broniowska K, Rohr F, Levy HL, Ney DM. Metabolomic Markers of Essential Fatty Acids, Carnitine, and Cholesterol Metabolism in Adults and Adolescents with Phenylketonuria. J Nutr 2018; 148:194-201. [PMID: 29490096 PMCID: PMC6251508 DOI: 10.1093/jn/nxx039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/05/2017] [Accepted: 11/08/2017] [Indexed: 12/12/2022] Open
Abstract
Background Individuals with phenylketonuria (PKU) have a risk of cognitive impairment and inflammation. Many follow a low-phenylalanine (low-Phe) diet devoid of animal protein in combination with medical foods (MFs). Objective To assess lipid metabolism in participants with PKU consuming amino acid MFs (AA-MFs) or glycomacropeptide MFs (GMP-MFs), we conducted fatty acid and metabolomics analyses. Methods We used subsets of fasting plasma and urine samples from our randomized crossover trial in which participants with early-treated classical and variant (milder) PKU consumed a low-Phe diet combined with AA-MFs or GMP-MFs for 3 wk each. Fatty acid profiles of red blood cell (RBC) membranes were determined for 25 adults (aged 18-49 y) with PKU and 143 control participants. Metabolomics analyses of plasma and urine samples were conducted by Metabolon for 9-10 adolescent and adult participants with PKU and for 15 control participants. Results RBC fatty acid profiles were not significantly different with AA-MFs or GMP-MFs. PKU participants showed higher total n-6:n-3 (ω-6:ω-3) fatty acids (mean ± SD percentages of total fatty acids: AA-MF = 5.45% ± 1.07%; controls = 4.33%; P < 0.001) and lower docosahexaenoic acid (DHA; AA-MF = 3.21% ± 0.98%; controls = 3.70% ± 1.01%; P = 0.02) and eicosapentaenoic acid (AA-MF = 0.33% ± 0.12%; controls = 0.60% ± 0.43%; P < 0.001) in RBCs than did control participants. Despite higher carnitine intake from AA-MFs than GMP-MFs (mean ± SE intake: AA-MFs = 58.6 ± 5.3 mg/d; GMP-MFs = 0.3 ± 0.01 mg/d; P < 0.001), plasma concentrations of carnitine were similar and not different from those in the control group (AA-MF compared with GMP-MF, P = 0.73). AA-MFs resulted in higher urinary excretion of trimethylamine N-oxide (TMAO), which is synthesized by bacteria from carnitine, compared with GMP-MFs (mean ± SE scaled intensity-TMAO: AA-MFs = 1.2 ± 0.1, GMP-MFs = 0.9 ± 0.1; P = 0.005). Plasma deoxycarnitine was lower in PKU participants than in control participants, suggesting reduced carnitine biosynthesis in PKU (AA-MF = 0.9 ± 0.1; GMP-MF = 1.0 ± 0.1; controls = 1.3 ± 0.1; AA-MF compared with controls, P = 0.01; GMP-MF compared with controls, P = 0.04). Conclusions Supplementation with DHA is needed in PKU. Carnitine supplementation of AA-MFs shows reduced bioavailability due, in part, to bacterial degradation to TMAO, whereas the bioavailability of carnitine is greater with prebiotic GMP-MFs. This trial was registered at www.clinicaltrials.gov as NCT01428258.
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Affiliation(s)
- Bridget M Stroup
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Nivedita Nair
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | - Sangita G Murali
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
| | | | - Fran Rohr
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Harvey L Levy
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Denise M Ney
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI
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