Zhen · Frontiers in endocrinology 2023 · narrative review · n=?

The gut microbial metabolite trimethylamine N-oxide and cardiovascular diseases.

Cited 221 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review without systematic search or meta-analytic pooling

PubMed 36824355 · doi:10.3389/fendo.2023.1085041 · record verified 2026-08-30

What was done

This narrative review synthesizes literature regarding the biochemical characteristics of gut microbial metabolite trimethylamine N-oxide (TMAO), its production pathway from dietary choline and L-carnitine, and mechanisms linking elevated TMAO to various cardiovascular diseases including atherosclerosis, heart failure, hypertension, arrhythmia, and coronary artery disease.

What was found

The abstract reports no quantitative values, effect sizes, or confidence intervals. It qualitatively reports that TMAO impairs cholesterol metabolism, promotes platelet aggregation and thrombosis, accelerates atherosclerosis, and correlates with worse prognosis in cardiovascular diseases.

Why it matters

The review summarizes mechanistic links connecting the gut microbiota to cardiovascular disease pathogenesis, supporting TMAO-lowering pathways as potential therapeutic targets.

Limits

The paper is a non-systematic narrative review providing no primary empirical data, pooled quantitative estimates, or formal risk-of-bias assessments. The abstract does not report the number of studies reviewed or inclusion criteria.

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