ArticleNature2011
Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.
Article in Nature, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 11 registered trials, which are not on this map. Cited by 2,993 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Low Fat Vegan Diet or American Heart Association Diet, Impact on Biomarkers of Inflammation, Oxidative Stress and Cardiovascular Risk in Obese 9-18 y.o. With Elevated Cholesterol: A Four Week Randomized Trial
Gut Flora Metabolite Reduction After Dietary Intervention (GRADY)
Impact of Diet and Gut Microbiota on Trimethylamine-N-oxide Production and Fate in Humans
Effects of Choline From Eggs vs. Supplements on the Generation of TMAO in Humans (EGGS)
Effect of Choline Source and Gut Microbiota Composition on Trimethylamine-N-oxide Response in Humans
Effects of Choline Supplementation on Fetal Growth in Gestational Diabetes Mellitus
Analysis of MicroBial Metabolites After Eating Refined Food
Plant-Based Meat vs Animal "Red" Meat: a Randomized Cross-over Trial
Effect of Resistant Starch on Symptom Improvement and Intestinal Microbiome in Patients With Functional Constipation
Effect of Ear Vagus Nerve Stimulator on Symptom Improvement and Intestinal Microbiome in Patients With Irritable Bowel
Additional Daily Intake of Eggs for Improving Metabolic Outcomes and Choline Levels in Individuals With Obesity: Phase I Study
Who cites it
2,993 citing papers in PubMed, 2 syntheses or guidelines pooled it, 5,443 citations in OpenAlex.
- Gut, Oral, and Fungal Microbiota in Hypertension: A Multi-Compartment Systematic Review.International journal of molecular sciences · 2026Pooled it
- Heart-Gut Axis in Cardiometabolic Disease: Microbiome-Mediated Pathways Linking Metabolic Syndrome to Cardiovascular Risk.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Effects of SGLT-2 Inhibitors on Plasma Concentrations and Renal Clearance of the Risk Marker Trimethylamine-N-Oxide in Patients With Type-2 Diabetes.Endocrinology, diabetes & metabolism · 2026Trial
- Trimethylamine N-oxide (TMAO) as a prognostic marker among patients at nutritional risk. A secondary analysis of the randomized clinical trial EFFORT.European journal of clinical nutrition · 2026Trial
- Processed plant-based meat-supplemented diet versus red meat-based supplemented diet randomized cross-over trial Finding Optimal Oral Diet-1 (FOOD-1) trial.Scientific reports · 2026Trial
- Advances and perspectives in genetically encoded biosensors for biomarker detection and theranostic circuits.Synthetic and systems biotechnology · 2027Review
- Gut microbiota shaping fatty liver disease progression.Life science alliance · 2027Review
- Gut-derived bacterial extracellular vesicles: the microbial dark matter contributing to host inflammation and cardiometabolic disease.Gut microbes · 2026Review
- Review
- Precise probiotic therapy: Advances, bottlenecks, and the road to microbiome-informed nutrition.Gut microbes · 2026Review
- Cardiovascular-kidney-metabolic syndrome through the lens of gut‑derived uremic toxins.Gut microbes · 2026Review
- Comparative insights into the gut-heart axis: cross-species and cross-population perspectives.Gut microbes · 2026Review
- Gut microbiota metabolic reprogramming drives the development of metabolic diseases in the host.Gut microbes · 2026Review
- Invasion of gut-derived escherichia coli extracellular vesicles exacerbates myocardial ischemia/reperfusion injury.Gut microbes · 2026Article
- Review
- Microbial metabolite-driven mechanisms linking the gut microbiome to atherosclerosis: multi-omic and translational perspectives.Gut microbes · 2026Review
- Article
- Review
- Dietary modulation of the gut microbiota in type 2 diabetes and obesity: mechanisms, interventions, and clinical perspectives.Acta diabetologica · 2026Review
- A roadmap towards clinical use of molecular biomarkers in acute ischaemic stroke.Nature reviews. Neurology · 2026Review
2,933 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors at 4 institutions in 1 country.
Funding
Abstract
Metabolomics studies hold promise for the discovery of pathways linked to disease processes. Cardiovascular disease (CVD) represents the leading cause of death and morbidity worldwide. Here we used a metabolomics approach to generate unbiased small-molecule metabolic profiles in plasma that predict risk for CVD. Three metabolites of the dietary lipid phosphatidylcholine--choline, trimethylamine N-oxide (TMAO) and betaine--were identified and then shown to predict risk for CVD in an independent large clinical cohort. Dietary supplementation of mice with choline, TMAO or betaine promoted upregulation of multiple macrophage scavenger receptors linked to atherosclerosis, and supplementation with choline or TMAO promoted atherosclerosis. Studies using germ-free mice confirmed a critical role for dietary choline and gut flora in TMAO production, augmented macrophage cholesterol accumulation and foam cell formation. Suppression of intestinal microflora in atherosclerosis-prone mice inhibited dietary-choline-enhanced atherosclerosis. Genetic variations controlling expression of flavin monooxygenases, an enzymatic source of TMAO, segregated with atherosclerosis in hyperlipidaemic mice. Discovery of a relationship between gut-flora-dependent metabolism of dietary phosphatidylcholine and CVD pathogenesis provides opportunities for the development of new diagnostic tests and therapeutic approaches for atherosclerotic heart disease.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.