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Meta-Analysis
. 2024 Jan 5;103(1):e36784.
doi: 10.1097/MD.0000000000036784.

Relationship between trimethylamine N-oxide and the risk of hypertension in patients with cardiovascular disease: A meta-analysis and dose-response relationship analysis

Jia-Ming Han  1 , Lu Guo  1 , Xian-Hui Chen  1 , Qian Xie  1 , Xiu-Ying Song  1 , Yu-Lan Ma  2
Affiliations
Meta-Analysis

Relationship between trimethylamine N-oxide and the risk of hypertension in patients with cardiovascular disease: A meta-analysis and dose-response relationship analysis

Jia-Ming Han et al. Medicine (Baltimore). .

Abstract

Background: The gut microbiota-dependent metabolite trimethylamine N-oxide (TMAO) has recently been recognized to be one of the risk factors for cardiovascular disease (CVD). However, there is a scarcity of data on the relationship between circulating TMAO levels and hypertension in patients with CVD. Meta analysis and a dose-response relationship were used in this study to assess the relationship between circulating trimethylamine N-oxide levels and the risk of hypertension in patients with CVD.

Methods: CNKI, Wanfang Database, Pubmed, Embase, Cochrane Library, and Web of Science were searched up to June 01, 2023. Meta-analysis and dose-response analysis of relative risk data from prospective cohort studies reporting on the relationship between circulating TMAO levels and hypertension risk in patients with CVD were conducted.

Results: Fifteen studies with a total of 15,498 patients were included in the present meta-analysis. Compared with a lower circulating TMAO level, a higher TMAO level was associated with a higher risk of hypertension in patients with CVD (RR = 1.14,95%CI (1.08, 1.20)). And the higher the TMAO level, the greater the risk of hypertension. The dose-response analysis revealed a linear dose-response relationship between circulating TMAO levels and the risk of hypertension in patients with CVD. The risk of hypertension increased by 1.014% when the circulating TMAO level increased by 1 μ mol/L.

Conclusion: In patients with CVD, the level of circulating TMAO is significantly related to the risk of hypertension. The risk of hypertension increased by 1.014% for every 1 μ mol/L increase in circulating TMAO levels.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flow chart of the study selection for the meta-analysis.
Figure 2.
Figure 2.
Forest plot of the relationship between circulating TMAO levels and the risk of hypertension in patients with cardiovascular disease. TMAO = trimethylamine N-oxide.
Figure 3.
Figure 3.
Funnel diagram of the relationship between circulating TMAO levels and risk of hypertension in patients with cardiovascular disease. TMAO = trimethylamine N-oxide.
Figure 4.
Figure 4.
Sensitivity analysis of the relationship between circulating TMAO levels and the risk of hypertension in patients with cardiovascular disease. TMAO = trimethylamine N-oxide.
Figure 5.
Figure 5.
Dose-response relationship between circulating TMAO levels and the risk of hypertension in patients with cardiovascular disease. TMAO = trimethylamine N-oxide.
See this image and copyright information in PMC

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