| Literature DB >> 33262105 |
Stavroula Argyridou1,2, Dennis Bernieh2,3, Joseph Henson1,2, Charlotte L Edwardson1,2, Melanie J Davies1,2, Kamlesh Khunti1,4, Toru Suzuki2,3, Thomas Yates5,2.
Abstract
INTRODUCTION: Trimethylamine N-oxide (TMAO) has been identified as a novel gut-derived molecule that is associated with the risk of cardiometabolic diseases. However, the relationship between TMAO and physical activity is not well understood. This study prospectively investigates the association between TMAO and objectively assessed physical activity in a population at high risk of type 2 diabetes mellitus. RESEARCH DESIGN AND METHODS: Baseline and 12-month follow-up data were used from the Walking Away from Type 2 Diabetes trial, which recruited adults at high risk of type 2 diabetes from primary care in 2009-2010. TMAO was analyzed using targeted mass spectrometry. Generalized estimating equation models with an exchangeable correlation structure were used to investigate the associations between accelerometer-assessed exposures (sedentary time, light physical activity, moderate to vigorous physical activity (MVPA)) and TMAO, adjusting for demographic, clinical and lifestyle factors in varying degrees.Entities:
Keywords: cardiovascular disease(s); diet; physical activity; type 2 diabetes
Mesh:
Substances:
Year: 2020 PMID: 33262105 PMCID: PMC7709505 DOI: 10.1136/bmjdrc-2020-001359
Source DB: PubMed Journal: BMJ Open Diabetes Res Care ISSN: 2052-4897
Figure 1Flow diagram of included participants.
Demographics, metabolic, anthropometric, physical activity and dietary characteristics of included participants (n=483)
| Characteristics | Baseline | n | 12-month follow-up | n |
| Age (years) | 63.5±7.3 | 483 | ||
| Sex | ||||
| Men | 316 (65.4) | |||
| Women | 167 (34.6) | |||
| Smoking status | ||||
| Never smoked | 445 (92.1) | |||
| Current smokers | 38 (7.9) | |||
| Ethnicity | ||||
| White European | 437 (90.5) | |||
| Other | 46 (9.5) | |||
| Treatment group | ||||
| Intervention | 246 (50.9) | |||
| Control | 237 (49.1) | |||
| Kidney function | 446 | 438 | ||
| Healthy | 155 (34.8) | 112 (25.5) | ||
| Mildly impaired | 271 (60.8) | 301 (68.4) | ||
| Moderately impaired | 20 (4.5) | 25 (5.7) | ||
| Body mass index (kg/m2) | 32.2±5.5 | 483 | 31.9±5.6 | 481 |
| Systolic blood pressure (mm Hg) | 143.2±18.4 | 483 | 133.1±17.2 | 481 |
| HbA1c (%) | 5.9 (5.6–6.1) | 481 | 5.9 (5.7–6.1) | 478 |
| HDL cholesterol (mmol/L) | 1.4 (1.2–1.6) | 482 | 1.3 (1.2–1.6) | 476 |
| Triglycerides (mmol/L) | 1.4 (0.9–1.7) | 483 | 1.3 (1.0–1.9) | 481 |
| TMAO (μmol/L) | 4.8 (3.1–7.5) | 483 | 5.0 (3.4–8.0) | 483 |
| Physical activity variables | ||||
| Accelerometer variables | ||||
| Wear time (min/day) | 860.5±85.3 | 446 | 857.2±84.9 | 440 |
| Sedentary time (min/day) | 542.5±102.9 | 550.4±103.9 | 440 | |
| Light‐intensity physical activity (min/day) | 289.6±78.3 | 280.2±79.9 | 440 | |
| Moderate to vigorous‐intensity physical activity (min/day) | 28.4±24.5 | 26.7±22.3 | 440 | |
| Dietary variables | ||||
| Red meat (beef, pork or lamb) (servings/week) | 4.0 (1.5–4.0) | 387 | 4.0 (1.5–4.0) | 319 |
| Fish (servings/week) | 1.5 (0.0–1.5) | 336 | 1.5 (0.0–1.5) | 336 |
Continuous parametric results are displayed as mean±SD or number (percentage), and continuous non-parametric results are displayed as median (IQR); sedentary time=<25 counts/15 s, light-intensity activity ≥25 to <488 counts/15 s, and moderate to vigorous physical activity (MVPA) ≥488 counts/15 s.
HDL, high-density lipoprotein; TMAO, trimethylamine N-oxide.
Figure 2Association between physical activity exposures and trimethylamine N-oxide (TMAO). Model 1: unadjusted. Model 2: age, sex, ethnicity, smoking status, treatment group, wear time. Model 3: model 2+kidney function, high-density lipoprotein (HDL) cholesterol, triglycerides, body mass index (BMI), systolic blood pressure, HbA1c, lipid-lowering medication, blood pressure-lowering medication. Model 4: model 3+red meat and fish. MVPA, moderate to vigorous physical activity.
Sensitivity analysis showing associations with TMAO (μmol/L) when MVPA and sedentary time were mutually adjusted
| Covariate | Coefficient per 30 min (95% CI) | Coefficient per SD | P value | Participants (n) | Observations included (n) |
| MVPA | −0.561 (−1.119 to −0.004) | −0.438 (−0.003 to 0.873) | 0.048 | 449 | 738 |
| Sedentary time | 0.017 (−0.168 to 0.202) | 0.059 (−0.575 to 0.692) | 0.933 | 449 | 738 |
Model mutually adjusted for MVPA and sedentary time along with age, sex, ethnicity, time, smoking status, randomization group, accelerometer wear time, kidney function, high-density lipoprotein (HDL) cholesterol, triglycerides, body mass index (BMI), systolic blood pressure, HbA1c, lipid-lowering medication, blood pressure-lowering medication, meat intake, and fish intake.
MVPA, moderate to vigorous physical activity; TMAO, trimethylamine N-oxide.