Relationship of Serum Trimethylamine N-Oxide (TMAO) Levels with early Atherosclerosis in Humans
Open accessAbstract
Circulating trimethylamine N-Oxide (TMAO) levels predict cardiovascular disease (CVD), possibly by impacting on cholesterol metabolism and oxidative stress. Because hepatic TMAO production is regulated by insulin signalling and it is unclear whether and to what extent circulating TMAO levels associate with CVD risk, independently of insulin resistance and its important determinants fatty liver and visceral obesity, we have now addressed this question in 220 subjects who participated in the Tübingen Lifestyle Intervention Program. Visceral fat mass (r = 0.40, p < 0.0001), liver fat content (r = 0.23, p = 0.0005) and TMAO levels (r = 0.26, p < 0.0001) associated positively, and insulin sensitivity associated negatively (r = -0.18, p = 0.009) with carotid intima-media thickness (cIMT). Higher TMAO levels (std.-Beta 0.11, p = 0.03) predicted increased cIMT, independently of age, sex and visceral fat mass. While during the lifestyle intervention most cardiovascular risk parameters improved, mean TMAO levels did not change (p = 0.18). However, cIMT decreased significantly (p = 0.0056) only in subjects in the tertile with the largest decrease of TMAO levels (>20%). We provide novel information that increased serum TMAO levels associate with increased cIMT, independently of established cardiovascular risk markers, including insulin resistance, visceral obesity and fatty liver. Furthermore, the decrease of cIMT during a lifestyle intervention may be related to the decrease of TMAO levels.
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Higher levels of choline and trimethylamine N-oxide have been linked to metabolic disturbances that might increase colorectal cancer risk, including higher body mass index, greater visceral adiposity, insulin resistance, diabetes, and fatty liver.
“Higher levels of choline and TMAO have been linked to a spectrum of metabolic disturbances that might increase CRC risk, including higher BMI, greater visceral adiposity, insulin resistance, diabetes, and fatty liver.153, 154”
From Influence of the Gut Microbiome, Diet, and Environment on Risk of Colorectal Cancer (2020) · cites this paper as [153]
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- Authors
- Randrianarisoa, E., Lehn-Stefan, A., Wang, X., Hoene, M., Peter, A., Heinzmann, S. S., Zhao, X., Königsrainer, I., Königsrainer, A., Balletshofer, B., Machann, J., Schick, F., Fritsche, A., Häring, H.-U., Xu, G., Lehmann, R., & Stefan, N.
- Affiliations
- Helmholtz Munich (DE)
- Dalian Institute of Chemical Physics (CN)
- University of Tübingen (DE)
- Corresponding author
- Stefan, Norbert
- ORCID
- Venue
- Scientific Reports
- Published
- 2016-05-27
- Volume
- 6
- Issue
- 1
- Pages
- 26745-26745
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC4882652
- OpenAlex
- W2407875089
- Cited by
- 296
- References
- 10
- Citations by year
- 2026: 13 · 2025: 23 · 2024: 27 · 2023: 28 · 2022: 33 · 2021: 47 · 2020: 37 · 2019: 34 · 2018: 31 · 2017: 18 · 2016: 5
- FWCI
- 29.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Dalian Institute of Chemical Physics, CAS Institutional Repository (submittedVersion)
- Site cant be reached (submittedVersion, cc-by)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (STE 1096/1-3, KFO 114)
- National Natural Science Foundation of China (21321064, 21435006)
- Bundesministerium für Bildung und Forschung (21435006, 21321064)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Keywords
- trimethylamine N-oxide, carotid intima-media thickness, early atherosclerosis, cardiovascular risk, insulin resistance, visceral obesity, hepatic steatosis, liver fat, lifestyle intervention, serum biomarkers
- MeSH terms
- Adult, Female, Humans, Insulin Resistance, Male, Methylamines, Middle Aged, Oxidative Stress, Intra-Abdominal Fat, Adiposity, Atherosclerosis
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