ArticleThe Journal of clinical endocrinology and metabolism2019
Trimethylamine N-Oxide Metabolites in Early Pregnancy and Risk of Gestational Diabetes: A Nested Case-Control Study.
Article in The Journal of clinical endocrinology and metabolism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Association of maternal gut microbial metabolites with gestational diabetes mellitus: evidence from an original case-control study, meta-analysis, and Mendelian randomization.European journal of clinical nutrition · 2025Pooled it
- A scientometric visualization analysis of the gut microbiota and gestational diabetes mellitus.Frontiers in microbiology · 2025Pooled it
- Gut microbiota-derived metabolite trimethylamine-N-oxide and multiple health outcomes: an umbrella review and updated meta-analysis.The American journal of clinical nutrition · 2022Pooled it
- Choline status and related health outcomes in humans: A scoping review.Nutrition and health · 2026Article
- Choline and Its Companions: Inter-Related Roles of Choline and B Vitamins in Fetal Development and Offspring Health.Nutrients · 2026Review
- Longitudinal metabolomics reveals dynamic associations of trimethylamine N-oxide and precursors with the progression of gestational diabetes.BMC pregnancy and childbirth · 2026Article
- Upregulation of hepatic flavin-containing monooxygenase 3 by increased corticosterone via glucocorticoid receptor contributes to gestational diabetes mellitus.Drug metabolism and disposition: the biological fate of chemicals · 2025Article
- Gut Microbiota and Its Metabolites Modulate Pregnancy Outcomes by Regulating Placental Autophagy and Ferroptosis.Antioxidants (Basel, Switzerland) · 2025Review
- Subcutaneous adipose tissue compensates for the perturbations in circulating one-carbon metabolism in women with gestational diabetes.Acta diabetologica · 2025Article
- TMAO and diabetes: from the gut feeling to the heart of the problem.Nutrition & diabetes · 2025Review
- Maternal telomere length and oxidative stress in pregnancy: cross-sectional analysis with an exploratory examination of systemic inflammation.BMC pregnancy and childbirth · 2025Article
- Article
- Associations of first-trimester TMAO and its precursors with gestational diabetes mellitus: a pilot prospective cohort study.Frontiers in nutrition · 2025Article
- Associations of serum choline, betaine and trimethylamine N-oxide with gestational diabetes mellitus among Chinese pregnant women.BMJ nutrition, prevention & health · 2025Article
- A mixture of postbiotics/tyndallized probiotics reduces trimethylamine (TMA) in trimethylaminuria models: Evidence fromFrontiers in pharmacology · 2025Article
- Gut Microbe-Generated Metabolite Trimethylamine-N-Oxide and Ischemic Stroke.Biomolecules · 2024Review
- Choline and betaine intakes during pregnancy in relation to risk of gestational diabetes mellitus among Chinese women.The British journal of nutrition · 2024Article
- Serum betaine and dimethylglycine in mid-pregnancy and the risk of gestational diabetes mellitus: a case-control study.Endocrine · 2024Article
- Distinct Plasma Metabolomic and Gut Microbiome Profiles after Gestational Diabetes Mellitus Diet Treatment: Implications for Personalized Dietary Interventions.Microorganisms · 2024Article
- Exposure Patterns of Multiple Pesticides and Urinary Alterations of Trimethylamine (TMA) and Trimethylamine N-Oxide (TMAO) among Pregnant Women.Environment & health (Washington, D.C.) · 2024Article
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 3 countries.
Funding
Abstract
objectivesThis study aimed to investigate the associations between trimethylamine N-oxide (TMAO) and related metabolites in early pregnancy and the risk of gestational diabetes mellitus (GDM).
designA prospective cohort of 22,302 pregnant women from 2010 to 2012 in Tianjin, China, was used to perform a nested case-control study. A total of 243 women with GDM and 243 women without GDM matched by maternal age (±1 year) were used as cases and controls, respectively. Conditional logistic regression and restricted cubic spline were used to examine the full-range risk associations between individual TMAOs metabolites at the first antenatal care visit with GDM. Trimethylamine conversion ratio (TMAR) was defined as trimethylamine (TMA)/its precursors, and trimethylamine N-oxide conversion ratio (TMAOR) was defined as TMAO/TMA. An additive interaction between high TMAR and low TMAOR indicates a state of TMA accumulation, and a mathematical interaction between high TMAR and high TMAOR indicates accumulation of TMAO.
resultsTMA was linearly associated with GDM, whereas TMA precursors and TMAO were inversely associated with GDM with clear threshold effects, i.e., 16 nmol/mL for TMAO, 200 nmol/mL for betaine, 112 nmol/mL for l-carnitine, and 110 and 270 nmol/mL for cholinechloride (a U-shaped relationship). Copresence of TMAR >0.35 and TMAOR ≤0.15 was associated with a markedly higher OR (11.16; 95% CI, 5.45 to 22.8), compared with TMAR >0.35 only (OR = 1.71; 95% CI, 0.42 to 6.95) or TMAOR ≤0.15 only (OR = 2.06; 95% CI, 1.09 to 3.90), with a significant additive interaction. However, the mathematical interaction was nonsignificant.
conclusionsTMAO metabolites in the early pregnancy were associated with the risk of GDM, whereas TMA was more likely to play a causal role in GDM.
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Registered trials
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