ArticleAtherosclerosis2023
Tryptophan metabolites and incident cardiovascular disease: The EPIC-Norfolk prospective population study.
Article in Atherosclerosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 43 citations in OpenAlex.
- The Gut Microbiota-Metabolite-Host Axis in Cardiometabolic Diseases: Bridging Bench to Bedside.Cardiovascular drugs and therapy · 2026Review
- Tryptophan Metabolism in Digestive and Extra-Digestive Diseases: Mechanisms, Clinical Implications, and Therapeutic Perspectives.Nutrients · 2026Review
- A machine learning approach to conglomerate multi-domain features of cardiac aging.European heart journal. Digital health · 2026Article
- Selective Activation of the Tryptophan-Kynurenine Pathway in Fontan Circulation.Pediatric cardiology · 2026Article
- Vascular Aging and Atherosclerosis: The Modulatory Impact of Selenium-A Comprehensive Review.Cells · 2026Review
- Research advancement on the correlation between gut microbiota and chronic kidney disease.Antonie van Leeuwenhoek · 2026Review
- The effect of 5MTP on the expression of inflammatory markers in human aortic endothelial cell.Acta diabetologica · 2026Article
- Tryptophan metabolites and stroke risk after acute myocardial infarction in patients with and without metabolic syndrome: insights from a MACCE-based cohort.Cardiovascular diabetology · 2026Article
- Plasma metabolomic signature of breastfeeding and risk of cardiometabolic diseases.Nature communications · 2025Article
- Successful endodontic treatment improves glucose and lipid metabolism: a longitudinal metabolomic study.Journal of translational medicine · 2025Article
- Comprehensive chemical analysis of polyphenols in the ethyl acetate extract from the roots of Ephedra sinica Stapf and evaluation of its therapeutic effects on SU5416/hypoxia-induced pulmonary arterial hypertension rats.Bioresources and bioprocessing · 2025Article
- Peroxidase-Catalyzed and Photo-Oxidation of Tryptophan Results in Distinct Isomeric Tryptophan Dimers.ACS omega · 2025Article
- Relationship between amino acid metabolism and inflammation in coronary heart disease (Review).International journal of molecular medicine · 2025Review
- Associations Between Serum Gut-Derived Tryptophan Metabolites and Cardiovascular Health Markers in Adolescents with Obesity.Nutrients · 2025Article
- A Comprehensive Review of the Role of the Microbiota-Gut-Brain Axis via Neuroinflammation: Advances and Therapeutic Implications for Ischemic Stroke.Biomolecules · 2025Review
- Effect of dapagliflozin on the serum metabolome in patients with type 2 diabetes mellitus.Journal of diabetes and metabolic disorders · 2025Article
- Kynurenine as a Predictor of Long-Term Mortality: A 10-Year Follow-Up from the KORONEF Registry.Biomedicines · 2025Article
- Decoding Blastocystis-Driven Mechanisms in Gut Microbiota and Host Metabolism.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- Indole metabolism and its role in diabetic macrovascular and microvascular complications.American heart journal plus : cardiology research and practice · 2025Review
- Gut Microbiota in Heart Failure-The Role of Inflammation.Biomedicines · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
Abstract
BACKGROUND AND
aimsCardiovascular disease (CVD) remains the largest cause of death globally due to various risk factors. One novel potential contributor to CVD might be the metabolism of the essential amino acid tryptophan (Trp), which through many pathways can produce immunomodulatory metabolites such as kynurenine, indole-3-propionate and serotonin. We aim to identify the metabolites with the strongest association with cardiovascular disease, utilizing a substantial and diverse cohort of individuals. In our pursuit of this aim, our primary focus is to validate and reinforce the findings from previous cross-sectional studies.
methodsWe used the community-based EPIC-Norfolk cohort (46.3 % men, age 59.8 ± 9.0) with a median follow-up of 22.1 (17.6-23.3) years to study associations between the relative levels of Trp metabolites measured with untargeted metabolomics and incident development of CVD. Serum from n = 11,972 apparently healthy subjects was analysed, of which 6982 individuals had developed CVD at the end of follow-up. Cox proportional hazard models were used to study associations, adjusted for sex, age, conventional cardiovascular risk factors and CRP. All metabolites were Ln-normalised prior to analysis.
resultsHigher levels of Trp were inversely associated with mortality (HR 0.73; CI 0.64-0.83) and fatal CVD (HR 0.76; CI 0.59-0.99). Higher levels of kynurenine (HR 1.33; CI 1.19-1.49) and the [Kynurenine]/[Tryptophan]-ratio (HR 1.24; CI 1.14-1.35) were associated with a higher incident development of CVD. Serotonin was not associated with overall CVD, but we did find associations for myocardial infarction and stroke. Adjustment for CRP did not yield any discernible differences in effect size.
conclusionsTryptophan levels were inversely correlated with CVD, while several of its major metabolites (especially kynurenine and serotonin) were positively correlated. These findings indicate that mechanistic studies are required to understand the role of Trp metabolism in CVD with the goal to identify new therapeutic targets.
Indexed as
Identifiers
What OpenQuestion holds
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.