Wan Zheng-Wei, Zheng Lin-Jie, Huang Yi-Fei, Xie Jing-Wen, Li Jian-Li, Chen Yi-Ran
Department of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
School of Public Health, Southern Medical University, Guangzhou, China.
J Transl Med. 2025 Jul 9;23(1):759. doi: 10.1186/s12967-025-06806-7.
Serum trimethylamine N-oxide (TMAO) level has been considered as a potential biomarker linking gut microbiota to multiple diseases. Prebiotics and phytochemicals have emerged as promising non-pharmacological agents for regulating TMAO levels and promoting overall health, attracting significant interest in recent research. However, existing evidence on their efficacy remains inconsistent. To address this, we conducted a systematic analysis of 41 studies (from PubMed, Web of Science, Embase, and Cochrane Library up to May 19, 2025) evaluating the effects of prebiotics and phytochemicals on gut microbiota and TMAO level. Included studies had interventional and longitudinal designs, analyzed gut microbiota, reported diversity or abundance measures, and measured changes in trimethylamine (TMA) or TMAO levels. Hedge's g standardized mean difference (SMD) and heterogeneity (I) were calculated to quantify the effects of prebiotics and phytochemicals on TMA, TMAO, and gut microbiota alpha-diversity. Microbial changes and beta-diversity were synthesized qualitatively. Our meta-analysis revealed that prebiotic and phytochemical interventions significantly reduced serum TMAO levels (SMD = - 2.31, 95% CI, - 2.75 to - 1.87; I = 76.00%, p < 0.01) in animals, with clinical trials showing similar results (SMD = - 0.82, 95% CI, - 1.55 to - 0.08, I = 91.00%, p < 0.01). In animals, TMA levels were also significantly reduced (SMD = - 1.53, 95% CI, - 2.04 to - 1.02; I = 71.00%, p < 0.01). Phytochemical and prebiotic interventions significantly caused alteration in the alpha- and beta-diversity of gut microbiota. Despite heterogeneity, consistent changes were noted in genera such as Akkermansia and Bifidobacterium. In conclusion, phytochemical and prebiotic interventions appear effective in reducing serum TMAO levels and are associated with changes in the composition and diversity of the gut microbiota. While these findings highlight the therapeutic potential of microbiota-targeted dietary strategies for TMAO reduction, they should be interpreted with caution due to the substantial heterogeneity among studies and the potential for publication bias. Further high-quality, standardized trials are needed to confirm these effects and support clinical translation.
血清氧化三甲胺（TMAO）水平被认为是一种将肠道微生物群与多种疾病联系起来的潜在生物标志物。益生元和植物化学物质已成为调节TMAO水平和促进整体健康的有前景的非药物制剂，在最近的研究中引起了极大关注。然而，关于它们疗效的现有证据仍然不一致。为了解决这个问题，我们对41项研究（截至2025年5月19日来自PubMed、Web of Science、Embase和Cochrane图书馆）进行了系统分析，评估益生元和植物化学物质对肠道微生物群和TMAO水平的影响。纳入的研究采用了干预性和纵向设计，分析了肠道微生物群，报告了多样性或丰度测量结果，并测量了三甲胺（TMA）或TMAO水平的变化。计算了Hedge's g标准化平均差（SMD）和异质性（I），以量化益生元和植物化学物质对TMA、TMAO和肠道微生物群α多样性的影响。对微生物变化和β多样性进行了定性综合分析。我们的荟萃分析显示，益生元和植物化学物质干预显著降低了动物血清TMAO水平（SMD = - 2.31，95%CI，- 2.75至- 1.87；I = 76.00%，p < 0.01），临床试验也显示了类似结果（SMD = - 0.82，95%CI，- 1.55至- 0.08，I = 91.00%，p < 0.01）。在动物中，TMA水平也显著降低（SMD = - 1.53，95%CI，- 2.04至- 1.02；I = 71.00%，p < 0.01）。植物化学物质和益生元干预显著导致肠道微生物群的α和β多样性发生改变。尽管存在异质性，但在诸如阿克曼氏菌和双歧杆菌等属中也注意到了一致的变化。总之，植物化学物质和益生元干预似乎在降低血清TMAO水平方面有效，并且与肠道微生物群的组成和多样性变化有关。虽然这些发现突出了以微生物群为靶点的饮食策略在降低TMAO方面的治疗潜力，但由于研究之间存在大量异质性以及存在发表偏倚的可能性，对这些发现应谨慎解释。需要进一步的高质量、标准化试验来证实这些效果并支持临床转化。
Zotero 插件