In the second phase of the study, the researchers measured TMAO levels in a large, independent, clinical cohort consisting of more than 4,000 adults undergoing cardiac evaluation at Cleveland Clinic over a three-year follow-up period. They found that higher TMAO blood levels were associated with higher future risks of death and nonfatal heart attack or stroke over the ensuing three-year period, independent of other risk factors and blood test results. These results complement those of another recent study of Dr. Hazen's linking gut flora metabolism of a structurally similar nutrient found in animal products, carnitine, to TMAO production and heart attack risk.
"Heart disease remains the No. 1 killer, and while we know how to reduce cholesterol, treat blood pressure, and reduce cardiac risks through diet and other interventions, a substantial residual risk still remains," Dr. Hazen said. "We need to find new pathways to attack heart disease, and these findings strongly suggest that further research into the involvement of gut microbiome in the development of cardiovascular disease could lead to new avenues of prevention and treatment of heart disease."
Dr. Hazen further suggested, "These studies show that measuring blood levels of TMAO could serve as a powerful tool for predicting future cardiovascular risk, even for those without known risk factors. More studies are needed to confirm that TMAO testing, like cholesterol, triglyceride or glucose levels, might help guide physicians in providing individualized nutritional recommendations for preventing cardiovascular disease. Our goal is not to suggest dietary restrictions of entire food groups. Eggs, meat and other animal products are an integral part of most individuals' diets. Our work shows, however, that when digesting these foods, gut flora can generate a chemical mediator, TM
|Contact: Laura Ambro|