Trimethylamine-N-oxide: a link between the gut microbiome, bile acid metabolism, and atherosclerosis
Abstract
PURPOSE OF REVIEW: This article evaluates the link between trimethylamine-N-oxide (TMAO) and bile acids and the consequent impact on the development of atherosclerosis. RECENT FINDINGS: Elevation in plasma TMAO concentrations is associated with an increased risk of cardiovascular disease in many different patient cohorts. In addition to the recently identified direct effects of TMAO on the development of atherosclerosis, other components involved in TMAO metabolism may also have an impact. Furthermore, the relationship between TMAO and bile acid regulation is emerging as a possible mediator of atherosclerosis. SUMMARY: Studies that are emerging highlight the mechanistic relationship of TMAO to the development atherosclerosis in addition to its role as disease biomarker. The interplay between TMAO and bile acid metabolism mediated through multiple factors, such as the gut microbiome, farnesoid X receptor signaling, and flavin monooxygenase 3 activity may help identify another pathway by which atherosclerosis occurs. In this review, we discuss the most recent data regarding atherosclerosis, TMAO, and bile acid metabolism.
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Prior reviews of TMAO and cardiovascular disease risk did not aim to perform a meta-analysis to quantify the risks of TMAO and its precursors for major adverse cardiovascular events.
“The associations of TMAO and the risk of CVDs have been reviewed previously42, 43, 44, 45; however, these studies did not aim to perform a meta‐analysis to quantify the risks of TMAO and its precursors for MACE.”
From Gut Microbiota Metabolites and Risk of Major Adverse Cardiovascular Disease Events and Death: A Systematic Review and Meta‐Analysis of Prospective Studies (2017) · cites this paper as [45]
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- Authors
- Wilson, A., McLean, C., & Kim, R. B.
- Affiliations
- Western University (CA)
- Corresponding author
- Wilson, Aze
- Venue
- Current Opinion in Lipidology
- Published
- 2016-04
- Volume
- 27
- Issue
- 2
- Pages
- 148-154
- ISSN
- 0957-9672 (ISSN-L)
- OpenAlex
- W2311976375
- Cited by
- 71
- References
- 8
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 5 · 2023: 9 · 2022: 9 · 2021: 13 · 2020: 6 · 2019: 5 · 2018: 3 · 2017: 12 · 2016: 5
- FWCI
- 0.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Lipidology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (MOP-89753)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- trimethylamine N-oxide, bile acids, bile acid metabolism, atherosclerosis, cardiovascular risk, gut microbiota, flavin monooxygenase 3, disease biomarkers
- MeSH terms
- Bacillota, Firmicutes, Gastrointestinal Microbiome, Animals, Bile Acids and Salts, Humans, Methylamines, Oxygenases, Atherosclerosis
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