Trimethylamine N-oxide is associated with long-term mortality risk: the multi-ethnic study of atherosclerosis

医学 氧化三甲胺 民族 内科学 期限(时间) 三甲胺 人类学 社会学 量子力学 物理 生物化学 化学
作者
Meng Wang,Xinmin S. Li,Zeneng Wang,Marcia C. de Oliveira Otto,Rozenn N. Lemaître,Amanda M. Fretts,Nona Sotoodehnia,Matthew J. Budoff,Ina Nemet,Joseph A. DiDonato,W.H. Wilson Tang,Bruce M. Psaty,David S. Siscovick,Stanley L. Hazen,Dariush Mozaffarian
出处
期刊:European Heart Journal [Oxford University Press]
卷期号:44 (18): 1608-1618 被引量:18
标识
DOI:10.1093/eurheartj/ehad089
摘要

Abstract Aims Little is known about associations of trimethylamine N-oxide (TMAO), a novel gut microbiota-generated metabolite of dietary phosphatidylcholine and carnitine, and its changes over time with all-cause and cause-specific mortality in the general population or in different race/ethnicity groups. The study aimed to investigate associations of serially measured plasma TMAO levels and changes in TMAO over time with all-cause and cause-specific mortality in a multi-ethnic community-based cohort. Methods and results The study included 6,785 adults from the Multi-Ethnic Study of Atherosclerosis. TMAO was measured at baseline and year 5 using mass spectrometry. Primary outcomes were adjudicated all-cause mortality and cardiovascular disease (CVD) mortality. Secondary outcomes were deaths due to kidney failure, cancer, or dementia obtained from death certificates. Cox proportional hazards models with time-varying TMAO and covariates assessed the associations with adjustment for sociodemographics, lifestyles, diet, metabolic factors, and comorbidities. During a median follow-up of 16.9 years, 1704 participants died and 411 from CVD. Higher TMAO levels associated with higher risk of all-cause mortality [hazard ratio (HR): 1.12, 95% confidence interval (CI): 1.08–1.17], CVD mortality (HR: 1.09, 95% CI: 1.00–1.09), and death due to kidney failure (HR: 1.44, 95% CI: 1.25–1.66) per inter-quintile range, but not deaths due to cancer or dementia. Annualized changes in TMAO levels associated with higher risk of all-cause mortality (HR: 1.10, 95% CI: 1.05–1.14) and death due to kidney failure (HR: 1.54, 95% CI: 1.26–1.89) but not other deaths. Conclusion Plasma TMAO levels were positively associated with mortality, especially deaths due to cardiovascular and renal disease, in a multi-ethnic US cohort.
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