Table 2 Summary of the studies evaluating the association of TMAO with cardiovascular risk in diabetes.
From: TMAO and diabetes: from the gut feeling to the heart of the problem
Study | Population | Outcome | Associations with TMAO | Comments |
|---|---|---|---|---|
Tang et al. [44] | Patients with type 2 diabetes, significant proportion of individuals with CVD | 3-year MACE 5-year mortality | HR 3.03 HR 3.63 | There was no strong correlation between TMAO and glycemic control. |
Lever et al. [38] | Patients after acute coronary event with type 2 diabetes | Mortality myocardial infarction heart failure unstable angina all CV events | HR 2.7 HR 4.0 HR 4.6 HR 9.1 HR 2.0 | In subjects without diabetes TMAO was only significant for death and heart failure. |
Croyal et al. [84] | Patients with type 2 diabetes with no evidence of nondiabetic renal disease | MACE Mortality | HR 1.32 HR 1.75 | Plasma TMAO concentrations were not associated with insulin resistance. |
Winther et al. [96] | Individuals with type 1 diabetes | Mortality Coronary events CVD events End-stage renal disease (ESRD) | HR 1.19 HR 1.21 HR 1.17 HR 1.67 | TMAO was not independently associated with cardiovascular and renal outcomes after adjusting for baseline eGFR. |
Flores-Guerrero et al. [82] | Patients with type 2 diabetes | CV mortality | HR 1.93 | |
Winther et al. [92] | Individuals with type 2 diabetes and albuminuria | Mortality CVD mortality Risk of CVD | no association no association no association | |
Sapa et al. [83] | Population of individuals with type 2 diabetes and chronic kidney disease | CV mortality Mortality Incident kidney failure with replacement therapy | HR 1.38 HR 1.13 no association | The lower ratio of urine to plasma TMAO concentration but not baseline plasma TMAO was associated with cardiovascular mortality and all-cause mortality. |
Eyileten et al. [86] | Individuals with acute coronary syndrome who underwent percutaneous coronary intervention, with type 2 diabetes | CV morality | HR 11.62 | |
Bao et al. [87] | Individuals newly diagnosed with coronary heart disease, with 48.1% having diabetes | Severity of CAD (correlation with SYNTAX score) Subgroup with diabetes | β = 0.179 No association | The correlations between TMAO and SYNTAX score did not hold true for subjects who were with histories of diabetes. No adjustment for GFR. |
Cardona et al. [89] | Population of individuals with type 2 diabetes and high atherosclerotic cardiovascular disease risk | MACE | no association | TMAO was not significantly associated with cardiovascular outcomes like MACE, CV death, or revascularization, TMAO levels were not influenced by renal function (eGFR). |
Schrauben et al. [90] | Individuals with type 2 diabetes and chronic kidney disease | Atherosclerotic CVD events Incident heart failure events | no association no association | |
Yu et al. [91] | Individuals with type 2 diabetes who underwent coronary angiography | Risk of triple vessel disease SYNTAX score >22 Presence of CAD | no association no association no association | No association in models adjusted for eGFR; significant correlation with increased coronary atherosclerotic burden was only observed in patients with reduced kidney function (eGFR <60 mL/min/1.73 m²). |
Wargny et al. [95] | Individuals with type 2 diabetes | Heart Failure Requiring Hospitalization (HFrH) HFrH and/or CV mortality All-cause mortality | HR 1.32 HR 1.31 HR 1.20 | No significant associations in fully adjusted models. |
Winther et al. [96] | Individuals with type 1 diabetes | All-cause mortality CV mortality Combined CVD Coronary events End-stage renal disease (ESRD) | HR 1.00 HR 1.00 HR 1.06 HR 1.03 HR 1.41 | The associations became insignificant after adjusting for baseline eGFR. |
