ArticleLiver international : official journal of the International Association for the Study of the Liver2021
Circulating trimethylamine-N-oxide is associated with all-cause mortality in subjects with nonalcoholic fatty liver disease.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- 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
- Canonical and Non-Canonical Regulators of Lipid Metabolism in the Liver and the "Liver-Other Organs" Axes.International journal of molecular sciences · 2026Review
- Trimethylamine N-oxide and major adverse cardiac and cerebrovascular events: results of umbrella review and meta-analysis.Nutrition & metabolism · 2026Article
- Effect Modification of Trimethylamine N-Oxide and Lipoprotein Insulin Resistance with Post-Transplantation Diabetes After Liver Transplant.International journal of molecular sciences · 2026Article
- Review
- Biomarkers for early identification of metabolic dysfunction-associated steatotic liver disease (MASLD): a narrative review.Archives of medical science : AMS · 2026Article
- Lipid-derived microbial metabolites at the gut-liver interface: regulation of intestinal barrier function, immune signaling, and metabolic inflammation.Frontiers in physiology · 2026Review
- Microbiome and metabolite signatures for cirrhosis to HCC risk stratification: progress, controversies, and gaps.Frontiers in cellular and infection microbiology · 2026Review
- Bacterial metabolic signatures in MASLD predicted through gene-centric studies in stool metagenomes.BMC microbiology · 2025Article
- The current findings on the gut-liver axis and the molecular basis of NAFLD/NASH associated with gut microbiome dysbiosis.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Shift in the urinary metabolome associated with 2,3,7,8-tetrachlorodibenzo-p-dioxin activation of the hepatic aryl hydrocarbon receptor.Scientific reports · 2025Article
- Gut microbiota in non-alcoholic fatty liver disease: Pathophysiology, diagnosis, and therapeutics.World journal of hepatology · 2025Review
- Intermittent fasting and metabolic dysfunction-associated steatotic liver disease: the potential role of the gut-liver axis.Cell & bioscience · 2025Review
- Trimethylamine-N-oxide, a New Risk Factor for Non-alcoholic Fatty Liver Disease Changes the Expression of miRNA-34a, and miRNA-122 in the Fatty Liver Cell Model.Biochemical genetics · 2025Article
- Gut microbiome and liver diseases.Fundamental research · 2025Review
- Targeting the gut microbiota and lipid metabolism: potential mechanisms of natural products for the treatment of non-alcoholic fatty liver disease.Frontiers in pharmacology · 2025Review
- Potential mechanisms of natural metabolites and botanical drugs foumulae for the treatment of non-alcoholic fatty liver disease: targeting the gut microbiota to modulate the immune system.Frontiers in pharmacology · 2025Review
- Circulating Gut Microbe-Derived Metabolites Are Associated with Hepatocellular Carcinoma.Biomedicines · 2024Article
- Circulating Trimethylamine-N-Oxide Is Elevated in Liver Transplant Recipients.International journal of molecular sciences · 2024Article
- Microfluidic gut-axis-on-a-chip models for pharmacokinetic-based disease models.Biomicrofluidics · 2024Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsTrimethylamine-N-oxide (TMAO), a gut microbiota-liver metabolite, has been associated with cardiometabolic disease. However, whether TMAO is associated with nonalcoholic fatty liver disease (NAFLD) and NAFLD-related health outcomes remains unclear. We aimed to investigate the association of TMAO with NAFLD and to assess the extent to which the association of TMAO with all-cause mortality is dependent on the presence of NAFLD in the general population.
methodsWe included 5292 participants enrolled in the Prevention of Renal and Vascular End-stage Disease (PREVEND) cohort study. Cox proportional-hazards regression analyses were performed to study the association of TMAO with all-cause mortality in subjects with and without a fatty liver index (FLI) ≥60, which was used as a proxy of NAFLD.
resultsDuring a median follow-up of 8.2 years, 307 subjects died, of whom 133 were classified with NAFLD. TMAO was positively and independently associated with baseline FLI (Std β 0.08, 95% CI 0.05, 0.11, P < .001). Higher TMAO was associated with increased risk of all-cause mortality in subjects with NAFLD, in crude analysis (hazard ratio [HR] per 1 SD, 2.55, 95% CI 1.60, 4.05, P < .001) and after full adjustment (
conclusionThis prospective study revealed that plasma concentrations of TMAO were associated with all-cause mortality in subjects with NAFLD, independently of traditional risk factors.
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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.