SynthesisThe American journal of clinical nutrition2022
Gut microbiota-derived metabolite trimethylamine-N-oxide and multiple health outcomes: an umbrella review and updated meta-analysis.
Synthesis in The American journal of clinical nutrition, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05795946 (Effects of a Whole Food Based Nutritional Formulation on Trimethylamine N-oxide and Cardiometabolic Endpoints in Healthy Adults.), which is not on this map. Cited by 105 papers, 6 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.
Effects of a Whole Food Based Nutritional Formulation on Trimethylamine N-oxide and Cardiometabolic Endpoints in Healthy Adults.
Who cites it
105 citing papers in PubMed, 6 syntheses or guidelines pooled it, 161 citations in OpenAlex.
- Associations of breastfeeding with maternal and child health outcomes: umbrella review.The American journal of clinical nutrition · 2025Pooled it
- The Effect of Red Meat Consumption on Circulating, Urinary, and Fecal Trimethylamine-N-Oxide: A Systematic Review and Narrative Synthesis of Randomized Controlled Trials.Advances in nutrition (Bethesda, Md.) · 2025Pooled it
- Gut microbiome and bone health: update on mechanisms, clinical correlations, and possible treatment strategies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled it
- Dietary inflammatory index and cardiovascular risk and mortality: an updated systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- Association between trimethylamine N-oxide and prognosis of patients with myocardial infarction: a meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled it
- Gut microbiota-derived trimethylamine N-oxide is associated with the risk of all-cause and cardiovascular mortality in patients with chronic kidney disease: a systematic review and dose-response meta-analysis.Annals of medicine · 2023Pooled 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
- Efficacy of probiotics (Bifidobacterium bifidum G9-1) in patients with type 2 diabetes mellitus and chronic kidney disease complicated by constipation: An exploratory, multicenter, open-label, single-arm study (BIRDIE study).Journal of diabetes investigation · 2026Trial
- Association between egg-derived phosphatidylcholine intake and trimethylamine N-oxide in healthy middle-aged and older adults.Lipids in health and disease · 2026Trial
- Effect of a polyphenol-rich pomegranate extract on plasma trimethylamine N-oxide levels following an oral carnitine challenge: a randomized controlled crossover trial in healthy adults.Frontiers in nutrition · 2026Trial
- Consumption of Different Egg-Based Diets Alters Clinical Metabolic and Hematological Parameters in Young, Healthy Men and Women.Nutrients · 2023Trial
- Cardiovascular-kidney-metabolic syndrome through the lens of gut‑derived uremic toxins.Gut microbes · 2026Review
- Review
- Targeting the Gut Microbiome in Cardiovascular Disease: Current Therapeutic Strategies and Future Perspectives.Nutrients · 2026Review
- Polyphenols as Systems Modulators of the Gut-Brain-Liver Axis: A Narrative Review of Neuro-Metabolic and Immunomodulatory Networks.Molecular nutrition & food research · 2026Review
- Trimethylamine N-oxide in exercise physiology: a gut microbiota-derived signal linking metabolic stress, redox balance and cardiometabolic health.European journal of applied physiology · 2026Review
- The Gut-Brain Axis in Metabolic Syndrome: Emerging Mechanisms and Perspectives in Personalized Medicine.International journal of molecular sciences · 2026Review
- Plasma trimethylamine N-oxide and related metabolites and overall survival of high-grade serous ovarian cancer: a nested case-control study.European journal of nutrition · 2026Article
- Isocaloric substitution of plant for animal protein and health-related quality of life in Spanish adolescents.European journal of nutrition · 2026Article
- Trimethylamine N-Oxide and Impaired Spermatogenesis in the Gut-Testis Axis: A Focused Review of Current Evidence.Biology · 2026Review
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 11 institutions in 5 countries.
Funding
Abstract
backgroundTrimethylamine-N-oxide (TMAO) is a gut microbiota-derived metabolite produced from dietary nutrients. Many studies have discovered that circulating TMAO concentrations are linked to a wide range of health outcomes.
objectivesThis study aimed to summarize health outcomes related to circulating TMAO concentrations.
methodsWe searched the Embase, Medline, Web of Science, and Scopus databases from inception to 15 February, 2022 to identify and update meta-analyses examining the associations between TMAO and multiple health outcomes. For each health outcome, we estimated the summary effect size, 95% prediction CI, between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate the evidence credibility of the identified associations.
resultsThis umbrella review identified 24 meta-analyses that investigated the association between circulating TMAO concentrations and health outcomes including all-cause mortality, cardiovascular diseases (CVDs), diabetes mellitus (DM), cancer, and renal function. We updated these meta-analyses by including a total of 82 individual studies on 18 unique health outcomes. Among them, 14 associations were nominally significant. After evidence credibility assessment, we found 6 (33%) associations (i.e., all-cause mortality, CVD mortality, major adverse cardiovascular events, hypertension, DM, and glomerular filtration rate) to present highly suggestive evidence.
conclusionsTMAO might be a novel biomarker related to human health conditions including all-cause mortality, hypertension, CVD, DM, cancer, and kidney function. Further studies are needed to investigate whether circulating TMAO concentrations could be an intervention target for chronic disease.This review was registered at www.crd.york.ac.uk/prospero/ as CRD42021284730.
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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.