Prognostic value of choline and betaine depends on intestinal microbiota-generated metabolite trimethylamine-N-oxide

摘要: Aims Recent metabolomics and animal model studies show trimethylamine- N -oxide (TMAO), an intestinal microbiota-dependent metabolite formed from dietary trimethylamine-containing nutrients such as phosphatidylcholine (PC), choline, carnitine, is linked to coronary artery disease pathogenesis. Our aim was examine the prognostic value of systemic choline betaine levels in stable cardiac patients. Methods results We examined relationship between fasting plasma risk major adverse events (MACE = death, myocardial infraction, stroke) relation TMAO over 3 years follow-up 3903 sequential subjects undergoing elective diagnostic angiography. In our study cohort, median (IQR) TMAO, were 3.7 (2.4–6.2)μM, 9.8 (7.9–12.2)μM, 41.1 (32.5–52.1)μM, respectively. Modest but statistically significant correlations noted ( r 0.33, P < 0.001) less 0.09, 0.001). Higher associated with a 1.9-fold 1.4-fold increased MACE, respectively (Quartiles 4 vs. 1; 0.01, each). Following adjustments for traditional cardiovascular factors high-sensitivity C-reactive protein, elevated [1.34 (1.03–1.74), 0.05], [1.33 (1.03–1.73), 0.05] each predicted MACE risk. Neither nor when added adjustment model, future only elevated. Conclusion Elevated are incident independent factors. However, high higher concomitant increase TMAO.