Longitudinal Measures of Trimethylamine N-oxide and Incident Atherosclerotic Cardiovascular Disease Events in Older Adults: The Cardiovascular Health Study

• Published in: Current developments in nutrition 2020-06, Vol.4 (Supplement_2), p.1434-1434, Article nzaa061_062
• Main Authors: Lee, Yujin, Wang, Zeneng, Lai, Heidi, de Oliveira Otto, Marcia, Lemaitre, Rozenn, Fretts, Amanda, Sotoodehnia, Nona, Budoff, Matthew, Didonato, Joseph, McKnight, Barbara, Tang, W.H. Wilson, Psaty, Bruce, Siscovick, David, Hazen, Stanley, Mozaffarian, Dariush
• Format: Article
• Language: English
• Subjects: Nutritional Epidemiology
• ISSN: 2475-2991; 2475-2991
• DOI: 10.1093/cdn/nzaa061_062

Trimethylamine N-oxide (TMAO) is a gut microbiota-dependent metabolite of dietary choline, L-carnitine and phosphatidylcholine-rich animal foods. Based on experimental studies and cohorts with prevalent disease, elevated TMAO may increase risk of atherosclerotic cardiovascular disease (ASCVD). TMAO is also renally cleared and may interact with and causally contribute to renal dysfunction and elevated cystatin-C. Yet, the associations of serial TMAO levels with incident ASCVD in a community-based prospective cohort, and the potential mediating and modifying role of renal function, are not established. We investigated the associations of serial measures of plasma TMAO, assessed at baseline and 7 years post baseline, with incident ASCVD among 4144 older adults in the Cardiovascular Health Study (CHS). TMAO was measured using stable isotope dilution LC/MS/MS (lab CV 60) [1.15 (0.96–1.37)], even with further adjustment for continuous eGFR. In this large community-based cohort of older US adults, higher serial measures of TMAO were associated with an elevated risk of ASCVD, in particular among those with impaired renal function. NIH, NHLBI.