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Long-Term Changes in Gut Microbial Metabolite Trimethylamine N-Oxide and Coronary Heart Disease RiskHeianza, Yoriko; Ma, Wenjie; DiDonato, Joseph A.; Sun, Qi; Rimm, Eric B.; Hu, Frank B.; Rexrode, Kathryn M.; Manson, JoAnn E.; Qi, Lu
Journal of the American College of Cardiology, 02/2020, Letnik: 75, Številka: 7Journal Article
A gut-microbial metabolite, trimethylamine N-oxide (TMAO), has been associated with coronary atherosclerotic burden. No previous prospective study has addressed associations of long-term changes in TMAO with coronary heart disease (CHD) incidence. The purpose of this study was to investigate whether 10-year changes in plasma TMAO levels were significantly associated with CHD incidence. This prospective nested case-control study included 760 healthy women at baseline. Plasma TMAO levels were measured both at the first (1989 to 1990) and the second (2000 to 2002) blood collections; 10-year changes (Δ) in TMAO were calculated. Incident cases of CHD (n = 380) were identified after the second blood collection through 2016 and were matched to controls (n = 380). Regardless of the initial TMAO levels, 10-year increases in TMAO from the first to second blood collection were significantly associated with an increased risk of CHD (relative risk RR in the top tertile: 1.58 95% confidence interval (CI): 1.05 to 2.38; RR per 1-SD increment: 1.33 95% CI: 1.06 to 1.67). Participants with elevated TMAO levels (the top tertile) at both time points showed the highest RR of 1.79 (95% CI: 1.08 to 2.96) for CHD as compared with those with consistently low TMAO levels. Further, we found that the ΔTMAO-CHD relationship was strengthened by unhealthy dietary patterns (assessed by the Alternate Healthy Eating Index) and was attenuated by healthy dietary patterns (p interaction = 0.008). Long-term increases in TMAO were associated with higher CHD risk, and repeated assessment of TMAO over 10 years improved the identification of people with a higher risk of CHD. Diet may modify the associations of ΔTMAO with CHD risk. Display omitted
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