The Influence of Trimethylamine-N-Oxide on the Risk of Cardiovascular Disease Progression



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Abstract

Modern dietary trends, marked by high consumption of animal products, drive the search for metabolic predictors of adverse course of cardiovascular pathology. Trimethylamine-N-oxide (TMAO), a metabolite derived from dietary precursors, is associated with mortality risk. However, a systemic understanding of the specific mechanisms by which TMAO promotes the progression of existing diseases warrants detailed investigation, including the strategies to regulate it.

This review examines the biochemical transformation pathway of TMAO, analyzes its role as a predictor of vascular endothelial dysfunction, and explores potential ways to control its blood concentration. Based on an analysis of studies published over the last five years, a clear link exists between plasma TMAO levels and the risk of cardiovascular disease. A tendency towards high TMAO levels is observed in people consuming animal products. The increase from the excessive synthesis of its precursor, trimethylamine, which is synthesized from dietary precursors. High TMAO concentrations exert pro-inflammatory effects, stimulate atherogenesis, and serve as a significant factor in vascular endothelial dysfunction. The cumulative effect of these pathological processes directly increases the risk of complications in patients with cardiac pathologies. Dietary restriction of animal products is a potential strategy to correct plasma TMAO levels. However, dietary modification alone cannot be regarded as the sole factor for reducing TMAO, as the functioning of the gut microbiota, which directly influences the formation of the TMAO precursor trimethylamine, is equally important.

This work provides a comprehensive understanding of the pathophysiological mechanisms by which TMAO affects the vascular wall and explains why dietary correction cannot be considered as the only method of prevention must be integrated with the management of gut microbiocenosis to effectively prevent disease.

About the authors

Rustem N. Khaуrullin

Interregional Clinical Diagnostic Center

Email: dr.kharu@gmail.com
ORCID iD: 0000-0002-2160-7720
SPIN-code: 1146-7585

MD, Dr. Sci. (Medicine), Academician of the Tatarstan Academy of Sciences, Honored Doctor of the Russian Federation and the Republic of Tatarstan, General Director

Russian Federation, Kazan

Regina M. Rakhimova

Interregional Clinical Diagnostic Center

Author for correspondence.
Email: mist-666@mail.ru

Doctor of clinical laboratory diagnostics

Russian Federation, Kazan

Irek Kh. Khusainov

Interregional Clinical Diagnostic Center, Kazan

Email: i@khusainovirek.ru
ORCID iD: 0000-0003-2466-6440
SPIN-code: 8634-1316

Head, bacteriology laboratory, executive director, Regional Medical Research Institute

Russian Federation, г. Казань

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