Demarquoy Jean
Unité Mixte de Recherche Procédés Alimentaires et Microbiologiques (UMR PAM), Institut Agro, Institut National de Recherche Pour L'agriculture, L'alimentation et L'environnement (INRAE), Université de Bourgogne, 21000 Dijon, France.
Nutrients. 2024 Dec 9;16(23):4244. doi: 10.3390/nu16234244.
L-Carnitine, sourced from red meat, dairy, and endogenous synthesis, plays a vital role in fatty acid metabolism and energy production. While beneficial for cardiovascular, muscular, and neural health, its interaction with the gut microbiota and conversion into trimethylamine (TMA) and trimethylamine N-oxide (TMAO) raise concerns about heart health. TMAO, produced through the gut-microbial metabolism of L-carnitine and subsequent liver oxidation, is associated with cardiovascular risks, including atherosclerosis, heart attacks, and stroke. It contributes to cholesterol deposition, vascular dysfunction, and platelet aggregation. Omnivorous diets, rich in L-carnitine, are associated with higher TMAO levels compared to plant-based diets, which are linked to lower cardiovascular disease risks. Dietary interventions, such as increasing fiber, polyphenols, and probiotics, can modulate the gut microbiota to reduce TMAO production. These strategies seek to balance L-carnitine's benefits with its potential risks related to TMAO production. Future research should focus on personalized approaches to optimize L-carnitine use while mitigating its cardiovascular impacts, exploring microbial modulation and dietary strategies to minimize the TMAO levels and associated risks.
左旋肉碱来源于红肉、乳制品以及内源性合成，在脂肪酸代谢和能量产生过程中发挥着至关重要的作用。虽然它对心血管、肌肉和神经健康有益，但其与肠道微生物群的相互作用以及转化为三甲胺（TMA）和氧化三甲胺（TMAO）引发了人们对心脏健康的担忧。TMAO是通过左旋肉碱的肠道微生物代谢以及随后的肝脏氧化产生的，与心血管风险相关，包括动脉粥样硬化、心脏病发作和中风。它会导致胆固醇沉积、血管功能障碍和血小板聚集。与植物性饮食相比，富含左旋肉碱的杂食性饮食与更高的TMAO水平相关，而植物性饮食与较低的心血管疾病风险相关。饮食干预措施，如增加纤维、多酚和益生菌的摄入，可以调节肠道微生物群以减少TMAO的产生。这些策略旨在平衡左旋肉碱的益处与其与TMAO产生相关的潜在风险。未来的研究应专注于个性化方法，以优化左旋肉碱的使用，同时减轻其对心血管的影响，探索微生物调节和饮食策略，以尽量降低TMAO水平及相关风险。
