ArticleLiver international : official journal of the International Association for the Study of the Liver2023
High plasma levels of betaine, a trimethylamine N-Oxide-related metabolite, are associated with the severity of cirrhosis.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03272841 (TransplantLines), which is not on this map. Cited by 13 papers.
What it found
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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.
TransplantLines: the Transplantation Biobank
Who cites it
13 citing papers in PubMed, 12 citations in OpenAlex.
- Article
- [Advances in the application of exhaled breath analysis technology in the detection and diagnosis of liver failure].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Bacterial Extracellular Vesicles in the Pathogenesis and Treatment of Liver Diseases.Journal of gastroenterology and hepatology · 2026Review
- The impact of a high-fat diet on liver health in pregnant mice and their offspring: The role of the gut-liver axis.iMetaOmics · 2025Article
- TransplantLines, a biobank and cohort study of solid organ transplant recipients and donors.European journal of epidemiology · 2025Observational
- Gut microbiome and liver diseases.Fundamental research · 2025Review
- Enhanced Chronic Inflammation and Increased Branched-Chain Amino Acids in Adrenal Disorders: A Cross-Sectional Study.The Journal of clinical endocrinology and metabolism · 2025Article
- Exercise-mimicking effects of betaine in chronic disease prevention and management.Frontiers in nutrition · 2025Review
- Linking Brain and Immune Transcriptomes to Gut-Derived Metabolites in Hepatic Encephalopathy: An Explorative Integrative Multi-Omics Approach.Hepatic medicine : evidence and research · 2025Article
- Trimethylamine N-oxide: a meta-organismal axis linking the gut and fibrosis.Molecular medicine (Cambridge, Mass.) · 2024Review
- Circulating Trimethylamine-N-Oxide Is Elevated in Liver Transplant Recipients.International journal of molecular sciences · 2024Article
- High plasma levels of betaine, a trimethylamine N-Oxide-related metabolite, are associated with the severity of cirrhosis.Liver international : official journal of the International Association for the Study of the Liver · 2023Article
- Integrated network analysis and metabolomics reveal the molecular mechanism of Yinchen Sini decoction in CClFrontiers in pharmacology · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsThe gut microbiome-related metabolites betaine and trimethylamine N-oxide (TMAO) affect major health issues. In cirrhosis, betaine metabolism may be diminished because of impaired hepatic betaine homocysteine methyltransferase activity, whereas TMAO generation from trimethylamine may be altered because of impaired hepatic flavin monooxygenase expression. Here, we determined plasma betaine and TMAO levels in patients with end-stage liver disease and assessed their relationships with liver disease severity.
methodsPlasma betaine and TMAO concentrations were measured by nuclear magnetic resonance spectroscopy in 129 cirrhotic patients (TransplantLines cohort study; NCT03272841) and compared with levels from 4837 participants of the PREVEND cohort study. Disease severity was assessed by Child-Pugh-Turcotte (CPT) classification and Model for End-stage Liver Disease (MELD) score.
resultsPlasma betaine was on average 60% higher (p < .001), whereas TMAO was not significantly lower in cirrhotic patients vs. PREVEND population (p = .44). After liver transplantation (n = 13), betaine decreased (p = .017; p = .36 vs. PREVEND population), whereas TMAO levels tended to increase (p = .085) to higher levels than in the PREVEND population (p = .003). Betaine levels were positively associated with the CPT stage and MELD score (both p < .001). The association with the MELD score remained in the fully adjusted analysis (p < .001). The association of TMAO with the MELD score did not reach significance (p = .11). Neither betaine nor TMAO levels were associated with mortality on the waiting list for liver transplantation (adjusted p = .78 and p = .44, respectively).
conclusionPlasma betaine levels are elevated in cirrhotic patients in parallel with disease severity and decrease after liver transplantation.
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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.