ArticleThe American journal of clinical nutrition2020
Associations of plasma trimethylamine N-oxide, choline, carnitine, and betaine with inflammatory and cardiometabolic risk biomarkers and the fecal microbiome in the Multiethnic Cohort Adiposity Phenotype Study.
Article in The American journal of clinical nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 3 of them syntheses that pooled it.
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Who cites it
113 citing papers in PubMed, 3 syntheses or guidelines pooled it, 165 citations in OpenAlex.
- A scientometric visualization analysis of the gut microbiota and gestational diabetes mellitus.Frontiers in microbiology · 2025Pooled it
- Pooled it
- Pooled it
- Is there a correlation between TMAO plasma levels and archaea in the gut of patients undergoing hemodialysis?International urology and nephrology · 2025Trial
- Changes in Choline Metabolites and Ceramides in Response to a DASH-Style Diet in Older Adults.Nutrients · 2023Trial
- Effects of a diet based on the Dietary Guidelines on vascular health and TMAO in women with cardiometabolic risk factors.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2022Trial
- Cardiovascular-kidney-metabolic syndrome through the lens of gut‑derived uremic toxins.Gut microbes · 2026Review
- Review
- Gut bacteria associated with an atherogenic TMAO-dietary pattern and choline-rich foods among aging women.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2026Article
- Associations of trimethylamine N-oxide and its precursors with hypertensive disorders of pregnancy, its subtypes and blood pressure in the offspring: findings from the Shanghai Birth Cohort.BMC pregnancy and childbirth · 2026Article
- Gut Microbiota and Chronic Kidney Disease: A Complex Interplay with Implications for Diagnosis and Treatment.Probiotics and antimicrobial proteins · 2026Review
- Erxian Decoction Ameliorates Myocardial Damage in Ovariectomized Rats by Regulating the Gut Microbiota and TMAO-Mediated NLRP3 Inflammatory Pathway.Journal of microbiology and biotechnology · 2026Article
- Potential influence of gut microbiota on the process of hypertriglyceridemia-aggravated acute pancreatitis.World journal of gastroenterology · 2026Review
- Gut microbiota-derived metabolites and IL-22 signaling in inflammatory bowel disease: context-dependent regulation of mucosal repair and inflammation.Frontiers in immunology · 2026Review
- The Association between β-Thalassemia Major (β-TM) and Cardiac Complications: Recent Insights.Current cardiology reviews · 2026Review
- Associations of Dietary and Circulating Choline and Glycine With Bone Mineral Density: UK Biobank Analyses With Mendelian Randomization.International journal of endocrinology · 2026Article
- Gut microbiota-cholesterol crosstalk in cardiovascular diseases: mechanisms, metabolites, and therapeutic modulation.Nutrition & metabolism · 2025Review
- Maternal Gut Microbiota in Gestational Diabetes Mellitus and Fetal Macrosomia: Is There an Association?Biomedicines · 2025Article
- Associations of Plasma Trimethylamine N -Oxide-Related Metabolites with the Development and Progression of Albuminuria : The Multiethnic Study of Atherosclerosis.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- The Impact of Gut Microbial Metabolomics on Type 2 Diabetes Development in People Living with HIV.Metabolites · 2025Review
53 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundTrimethylamine N-oxide (TMAO), a compound derived from diet and metabolism by the gut microbiome, has been associated with several chronic diseases, although the mechanisms of action are not well understood and few human studies have investigated microbes involved in its production.
objectivesOur study aims were 1) to investigate associations of TMAO and its precursors (choline, carnitine, and betaine) with inflammatory and cardiometabolic risk biomarkers; and 2) to identify fecal microbiome profiles associated with TMAO.
methodsWe conducted a cross-sectional analysis using data collected from 1653 participants (826 men and 827 women, aged 60-77 y) in the Multiethnic Cohort Study. Plasma concentrations of TMAO and its precursors were measured by LC-tandem MS. We also analyzed fasting blood for markers of inflammation, glucose and insulin, cholesterol, and triglycerides (TGs), and further measured blood pressure. Fecal microbiome composition was evaluated by sequencing the 16S ribosomal RNA gene V1-V3 region. Associations of TMAO and its precursors with disease risk biomarkers were assessed by multivariable linear regression, whereas associations between TMAO and the fecal microbiome were assessed by permutational multivariate ANOVA and hurdle regression models using the negative binomial distribution.
resultsMedian (IQR) concentration of plasma TMAO was 3.05 μmol/L (2.10-4.60 μmol/L). Higher concentrations of TMAO and carnitine, and lower concentrations of betaine, were associated with greater insulin resistance (all P < 0.02). Choline was associated with higher systolic blood pressure, TGs, lipopolysaccharide-binding protein, and lower HDL cholesterol (P ranging from <0.001 to 0.03), reflecting an adverse cardiometabolic risk profile. TMAO was associated with abundance of 13 genera (false discovery rate < 0.05), including Prevotella, Mitsuokella, Fusobacterium, Desulfovibrio, and bacteria belonging to the families Ruminococcaceae and Lachnospiraceae, as well as the methanogen Methanobrevibacter smithii.
conclusionsPlasma TMAO concentrations were associated with a number of trimethylamine-producing bacterial taxa, and, along with its precursors, may contribute to inflammatory and cardiometabolic risk pathways.
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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.