Liqiang Zheng1, Jia Zheng1, Yanxia Xie1, Zhao Li2, Xiaofan Guo2, Guozhe Sun2, Zhaoqing Sun3, Fuguo Xing4, Yingxian Sun5. 1. Department of Clinical Epidemiology, Library, Department of Health Policy and Hospital Management, Shengjing Hospital of China Medical University, Shenyang 110004, PR China. 2. Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, PR China. 3. Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, PR China. 4. Institute of Food Science and Technology, Chinese Academy of Agricultural Sciences, Beijing 100193, PR China. Electronic address: xingfuguo@caas.cn. 5. Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, PR China. Electronic address: sunyingxian12@126.com.
Abstract
BACKGROUND AND AIMS: Recent studies have shown that trimethylamine N-oxide (TMAO) is a risk factor for cardiovascular disease (CVD) in different clinical settings, but few studies confirmed the association in a community-based general population. METHODS: This is a nested case-control study from a prospective cohort design. A total of 86 newly diagnosed CVD cases with a median follow-up period of 4.83 years and 86 matched controls were selected for the present analysis. RESULTS: Using the LC-MS/MS assays, we found that new CVD cases had a higher baseline levels of TMAO than controls [median (inter-quartile): 1.57 (0.79-2.29) μmol/L v.s 0.68 (0.23-1.40) μmol/L, p < 0.001]. After multivariable adjustment, individuals with TMAO ≥1.89 μmol/L (Q4) and 1.05-1.89 μmol/L (Q3) had odds ratio (OR) for CVD of 2.735 [95% confidence interval (CI): 1.328-5.630] and 2.544 (95% CI: 1.251-5.172) with the lowest quartile (<0.43 μmol/L) as reference. In addition, comparisons of areas under receiver operator characteristics curves confirmed that a model including TMAO had a better discrimination than one without (0.732 vs. 0.664, p = 0.045). CONCLUSIONS: In the community-based general population, there was a positive association between TMAO and future risk of CVD. Addition of TMAO improved the prediction of CVD beyond traditional risk factors. We recommend considering TMAO as a potential novel preventive target in the management of low-risk CVD adults.
BACKGROUND AND AIMS: Recent studies have shown that trimethylamine N-oxide (TMAO) is a risk factor for cardiovascular disease (CVD) in different clinical settings, but few studies confirmed the association in a community-based general population. METHODS: This is a nested case-control study from a prospective cohort design. A total of 86 newly diagnosed CVD cases with a median follow-up period of 4.83 years and 86 matched controls were selected for the present analysis. RESULTS: Using the LC-MS/MS assays, we found that new CVD cases had a higher baseline levels of TMAO than controls [median (inter-quartile): 1.57 (0.79-2.29) μmol/L v.s 0.68 (0.23-1.40) μmol/L, p < 0.001]. After multivariable adjustment, individuals with TMAO ≥1.89 μmol/L (Q4) and 1.05-1.89 μmol/L (Q3) had odds ratio (OR) for CVD of 2.735 [95% confidence interval (CI): 1.328-5.630] and 2.544 (95% CI: 1.251-5.172) with the lowest quartile (<0.43 μmol/L) as reference. In addition, comparisons of areas under receiver operator characteristics curves confirmed that a model including TMAO had a better discrimination than one without (0.732 vs. 0.664, p = 0.045). CONCLUSIONS: In the community-based general population, there was a positive association between TMAO and future risk of CVD. Addition of TMAO improved the prediction of CVD beyond traditional risk factors. We recommend considering TMAO as a potential novel preventive target in the management of low-risk CVD adults.
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