Serum Trimethylamine N-Oxide Concentration Is Positively Associated With First Stroke in Hypertensive Patients

• DOI: 10.1161/strokeaha.118.021997
• Publication Date: 2018-09-04T15:56:51Z
• Authors: Jing Nie; Liling Xie; Bo-xin Zhao; Youbao Li; Bingbing Qiu; Fengxin Zhu; Guo-feng Li; Mingli He; Yu Wang; Binyan Wang; Side Liu; Hao Zhang; Huiyuan Guo; Yefeng Cai; Yong Huo; Fan Fan Hou; Xiping Xu; Xianhui Qin
• Keywords: Trimethylamine N-oxide; Stroke; Choline

Background and Purpose— Trimethylamine N-oxide (TMAO)—a gut derived metabolite—has been shown to be atherogenic. It remains unknown whether TMAO is associated with the risk of first stroke. We aimed determine association between serum levels stroke in hypertensive patients without major cardiovascular diseases examine any possible effect modifiers. Methods— used a nested case-control design, using data from CSPPT (China Stroke Primary Prevention Trial), including 622 matched controls. The study was conducted May 2008 August 2013. primary outcome Results— After adjusting for choline, L-carnitine, other important covariates, baseline systolic blood pressure time-averaged pressure, during treatment period, increased each increment level (per natural log [TMAO] increment: odds ratio, 1.22; 95% CI, 1.02–1.46). Consistently, compared participants lowest tertile (<1.79 μmol/L) levels, significantly higher found those tertiles (≥1.79 μmol/L; 1.34; 1.00–1.81) or 3 (≥3.19 1.43; 1.02–2.01). In exploratory analysis, we observed an interaction folate (≥7.7 [median] versus <7.7 ng/mL) on ( P interaction, 0.030). Conclusions— Higher were patients. Our finding, if further confirmed, calls carefully designed clinical trial evaluate role outcomes Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT00794885.