Molecular Medicine Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Nutr Rev. 2021 Aug 9;79(9):1022-1042. doi: 10.1093/nutrit/nuaa111.
Several studies suggest a relationship between trimethylamine N-oxide (TMAO) concentrations and increased cardiometabolic risk, but findings are controversial.
The aim of this systematic review and meta-analysis was to summarize evidence of the relationship between circulating TMAO levels and risk of hypertension and increased serum lipids in a dose-response and 2-class meta-analysis of discrete and continuous variables.
PubMed, Scopus, Cochrane, and ProQuest databases were searched.
Observational studies that reported disease status of participants (≥ 18 years), type of sample in which TMAO was measured (serum or plasma), and results based on at least 2 categories of TMAO concentrations, including relative risks, hazard ratios, or odds ratios with 95%CIs for cardiometabolic risk factors in association with circulating TMAO levels were selected. Papers were reviewed independently by both authors. The Newcastle-Ottawa Scale was used to assess the quality of included studies.
The following data were extracted: first author's name, publication year, study design, study location, demographic information of participants, and concentrations of circulating TMAO.
Eighteen studies were included in the meta-analysis. There was a dose-response relationship between circulating TMAO and increased odds of hypertension in cohort studies (P for nonlinearity = 0.049), in plasma-derived TMAO samples (P for nonlinearity = 0.043), in patients with cardiovascular disease (P for nonlinearity = 0.048), and in apparently healthy individuals from community-based studies (P for nonlinearity = 0.005). Moreover, the highest category of TMAO concentrations was associated with a 2.36 mmHg increase in systolic blood pressure when compared with the lowest category. The dose-response meta-analysis of continuous variables revealed that an increase in TMAO is associated with reduced high-density lipoprotein cholesterol in apparently healthy individuals and reduced high-density lipoprotein cholesterol and increased total cholesterol in patients with cardiovascular disease.
Circulating TMAO is positively associated with an increased risk of hypertension and other cardiometabolic disorders in adults.
PROSPERO identification number CRD42019138296.
有几项研究表明三甲胺 N-氧化物（TMAO）浓度与增加的心脏代谢风险之间存在关联，但研究结果存在争议。
本系统评价和荟萃分析的目的是总结循环 TMAO 水平与高血压风险和血脂升高之间关系的证据，采用离散和连续变量的 2 类荟萃分析来评估剂量反应。
检索了 PubMed、Scopus、Cochrane 和 ProQuest 数据库。
选择了报告参与者疾病状态（≥18 岁）、测量 TMAO 的样本类型（血清或血浆）以及至少 2 类 TMAO 浓度结果的观察性研究，包括相对风险、危险比或优势比，以及与循环 TMAO 水平相关的心脏代谢危险因素的 95%置信区间。由两位作者独立审查论文。使用纽卡斯尔-渥太华量表评估纳入研究的质量。
提取了以下数据：第一作者姓名、发表年份、研究设计、研究地点、参与者的人口统计学信息以及循环 TMAO 的浓度。
荟萃分析纳入了 18 项研究。在队列研究中（P 值非线性=0.049）、在血浆衍生 TMAO 样本中（P 值非线性=0.043）、在心血管疾病患者中（P 值非线性=0.048）和在来自社区为基础的研究的貌似健康个体中，循环 TMAO 与高血压发生几率呈剂量反应关系（P 值非线性=0.005）。此外，与最低类别相比，TMAO 浓度最高类别的收缩压增加了 2.36mmHg。连续变量的剂量反应荟萃分析表明，在貌似健康的个体中，TMAO 增加与高密度脂蛋白胆固醇降低相关，在心血管疾病患者中，TMAO 增加与高密度脂蛋白胆固醇降低和总胆固醇升高相关。
循环 TMAO 与成年人高血压和其他心脏代谢疾病的风险增加呈正相关。
PROSPERO 注册号 CRD42019138296。
