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Trimethylamine N-Oxide, a Gut Microbiota-Dependent Metabolite, is Associated with Frailty in Older Adults with Cardiovascular Disease

Authors He W, Luo Y, Liu JP, Sun N, Guo D, Cui LL, Zheng PP, Yao SM, Yang JF, Wang H

Received 10 July 2020

Accepted for publication 1 September 2020

Published 30 September 2020 Volume 2020:15 Pages 1809—1820


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Zhi-Ying Wu

Wei He,1,2 Yao Luo,1 Jun-Peng Liu,1 Ning Sun,1 Di Guo,1 Ling-Ling Cui,1 Pei-Pei Zheng,1 Si-Min Yao,1 Jie-Fu Yang,1,2 Hua Wang1,2

1Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, People’s Republic of China; 2Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China

Correspondence: Hua Wang; Jie-Fu Yang
Department of Cardiology, Beijing Hospital, National Center of Gerontology, No. 1, Dahua Road, Dongcheng District, Beijing 100730, People’s Republic of China
Tel +86 13911680467; +86 13601292259
Fax +86 10-58115035

Objective: Our study aimed to explore the association between trimethylamine N-oxide and frailty in older adults with cardiovascular disease.
Patients and Methods: This cross-sectional study analyzed a total of 451 people aged 65 years or older who underwent comprehensive geriatric assessments. Frailty status was determined using a frailty index constructed with 48 variables according to the cumulative deficits model. Physical frailty and cognitive frailty were also assessed in detail. Fasting plasma TMAO was measured by mass spectrometry.
Results: The proportion of frail subjects was 29.9% (135/451). Plasma TMAO levels were significantly higher in frail patients than in nonfrail individuals (4.04 [2.84– 7.01] vs 3.21 [2.13– 5.03] μM; p< 0.001). Elevated plasma TMAO levels were independently associated with the likelihood of frailty (OR 2.12, 95% CI 1.01– 4.38, p=0.046). Dose–response analysis revealed a linear association between the TMAO concentration and the OR for frailty. A 2-unit increase in TMAO was independently correlated with physical frailty (OR 1.23, 95% CI 1.08– 1.41, p for trend 0.002) and cognitive frailty (OR 1.21, 95% CI 1.01– 1.45, p for trend 0.04).
Conclusion: Elevated circulating TMAO levels are independently associated with frailty among older adults with cardiovascular disease.

Keywords: older adults, frailty, TMAO, cardiovascular disease, physical frailty, cognitive frailty

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