Trimethylamine N-oxide is associated with long-term mortality risk: the multi-ethnic study of atherosclerosis.
Eur Heart J
; 44(18): 1608-1618, 2023 05 07.
Article
in En
| MEDLINE
| ID: mdl-36883587
ABSTRACT
AIMS:
Little is known about associations of trimethylamine N-oxide (TMAO), a novel gut microbiota-generated metabolite of dietary phosphatidylcholine and carnitine, and its changes over time with all-cause and cause-specific mortality in the general population or in different race/ethnicity groups. The study aimed to investigate associations of serially measured plasma TMAO levels and changes in TMAO over time with all-cause and cause-specific mortality in a multi-ethnic community-based cohort. METHODS ANDRESULTS:
The study included 6,785 adults from the Multi-Ethnic Study of Atherosclerosis. TMAO was measured at baseline and year 5 using mass spectrometry. Primary outcomes were adjudicated all-cause mortality and cardiovascular disease (CVD) mortality. Secondary outcomes were deaths due to kidney failure, cancer, or dementia obtained from death certificates. Cox proportional hazards models with time-varying TMAO and covariates assessed the associations with adjustment for sociodemographics, lifestyles, diet, metabolic factors, and comorbidities. During a median follow-up of 16.9 years, 1704 participants died and 411 from CVD. Higher TMAO levels associated with higher risk of all-cause mortality [hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.08-1.17], CVD mortality (HR 1.09, 95% CI 1.00-1.09), and death due to kidney failure (HR 1.44, 95% CI 1.25-1.66) per inter-quintile range, but not deaths due to cancer or dementia. Annualized changes in TMAO levels associated with higher risk of all-cause mortality (HR 1.10, 95% CI 1.05-1.14) and death due to kidney failure (HR 1.54, 95% CI 1.26-1.89) but not other deaths.CONCLUSION:
Plasma TMAO levels were positively associated with mortality, especially deaths due to cardiovascular and renal disease, in a multi-ethnic US cohort.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiovascular Diseases
/
Dementia
/
Renal Insufficiency
/
Atherosclerosis
/
Neoplasms
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Eur Heart J
Year:
2023
Document type:
Article
Affiliation country: