Intra-individual variation of plasma trimethylamine-N-oxide (TMAO), betaine and choline over 1 year

Jul 23, 2016Clinical chemistry and laboratory medicine

Year-long changes in blood levels of TMAO, betaine, and choline within individuals

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Abstract

Correlations of fasting plasma TMAO levels over 1 year were found to be ρ=0.29.

TMAO levels showed a modest correlation over one year, indicating significant intra-individual variation.
Betaine and choline levels demonstrated stronger correlations of ρ=0.81 and ρ=0.61, respectively.
Plasma levels of TMAO did not significantly correlate with diet, lifestyle factors, or common health markers.
The variation in TMAO concentrations may affect interpretations of its association with cardiovascular and chronic kidney diseases.

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BACKGROUND: Circulating trimethylamine-N-oxide (TMAO) has been implicated in the development of cardiovascular and chronic kidney diseases (CKD). However, while higher TMAO levels have been associated with increased risks of cardiovascular or renal events in first prospective studies, it remained unclear how much plasma TMAO concentrations vary over time.

METHODS: We measured fasting plasma levels of TMAO and two of its precursors, betaine and choline by LC-MS, in two samples of 100 participants of the European Investigation into Cancer and Nutrition (EPIC)-Heidelberg study (age range: 47-80 years, 50% female) that were collected 1 year apart, and assessed their intra-individual variation by Spearman's correlation coefficients (ρ).

RESULTS: Correlations of metabolite concentrations over 1 year were at ρ=0.29 (p=0.003) for TMAO, ρ=0.81 (p<0.001) for betaine, and ρ=0.61 (p<0.001) for choline. Plasma levels of TMAO were not significantly associated with food intake, lifestyle factors, or routine biochemistry parameters such as C-reactive protein (CRP), low-density lipoprotein (LDL)-cholesterol, or creatinine.

CONCLUSIONS: In contrast to fasting plasma concentrations of betaine and choline, concentrations of TMAO were more strongly affected by intra-individual variation over 1 year in adults from the general population. The modest correlation of TMAO levels over time should be considered when interpreting associations between TMAO levels and disease endpoints.

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Intra-individual variation of plasma trimethylamine-N-oxide (TMAO), betaine and choline over 1 year

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