2020
DOI: 10.1017/s0954422420000177
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TrimethylamineN-oxide: heart of the microbiota–CVD nexus?

Abstract: We critically review potential involvement of trimethylamine-N-oxide (TMAO) as a link between diet, the gut microbiota and cardiovascular disease (CVD). Generated primarily from dietary choline and carnitine by gut bacteria and hepatic flavin monooxygenase (FMO) activity, TMAO could promote cardiometabolic disease when chronically elevated. However, control of circulating TMAO is poorly understood, and diet, age, body mass, sex hormones, renal clearance, FMO3 expression and genetic background may explain as li… Show more

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Cited by 50 publications
(48 citation statements)
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References 230 publications
(560 reference statements)
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“…TMAO is then transported to tissues or excreted into the urine. TMAO acts atherogenic [120][121][122][123][124]. Updated systematic review and meta-analysis indicate that TMAO increased the hazard ratio (HR) of CHD mortality [125].…”
Section: Debates Around Trimethylamine Oxide (Tmao)mentioning
confidence: 99%
“…TMAO is then transported to tissues or excreted into the urine. TMAO acts atherogenic [120][121][122][123][124]. Updated systematic review and meta-analysis indicate that TMAO increased the hazard ratio (HR) of CHD mortality [125].…”
Section: Debates Around Trimethylamine Oxide (Tmao)mentioning
confidence: 99%
“…The formation by gut microbiota of secondary bile acids from host cell-derived bile acids seems to mostly have the function of inactivating the latter, which variedly affect metabolism and inflammation (Delzenne et al 2020). Other metabolites may be derived from the diet, such as trimethylamine-N-oxide, which is associated with obesity and its cardiovascular consequences (Naghipour et al 2020). Metabolites produced by commensal microorganisms following the dietary intake of certain food components, such as the polyphenols, may differ among individuals with different capabilities of metabolising them, that is, different 'metabotypes' (Noerman et al 2020).…”
mentioning
confidence: 99%
“…It is important to understand which foods or which other nutritional strategies (e.g., cooking method or selective microbiome intervention) have a greater effect on plasma TMAO levels, as this would allow for better nutritional prescribing, particularly in patients with modestly impaired renal function [ 9 ] and type-2 diabetes mellitus (T2DM) [ 46 ] (in which TMAO has been demonstrated to have even more deleterious effects on CVD risk). Some authors have proposed that a simpler method of reducing TMAO might be to eat fewer foods containing TMA precursors and increase those that favour non-TMA-producing bacteria (e.g., vegetables/fruit) or suppression of FMO3 activity (e.g., vegetables containing indole) [ 47 ].…”
Section: Discussionmentioning
confidence: 99%