Increasing trimethylamine N-oxide levels as a predictor of early neurological deterioration in patients with acute ischemic stroke.

In this study, we aimed to investigate whether serum TMAO levels could predict early neurological deterioration (END) after acute ischemic stroke.Methods: We prospectively recruited patients with first-ever ischemic stroke and hospitalized within 24 h of symptoms onset during Mar 2018 to Mar 2019. Plasma TMAO levels were quantified using stable isotope dilution high-performance liquid chromatography with tandem mass spectrometry after admission. END was defined as an increase in the total National Institutes of Health Stroke Scale by 2 or more points within 3 days.Results: Of the 362 patients included, END was diagnosed in 97 subjects (26.8%). The median TMAO concentrations were 4.8 μmol/L, with tertile levels as follows: first tertile (5.6 μmol/L). Patients with END showed higher levels of TMAO (median 5.0 vs. 4.5 μmol/L, P = 0.005) at admission. In univariate logistic analysis, elevated plasma levels of TMAO [odd ratios for highest tertile vs. lowest tertile, 2.14; 95% confidence interval, 1.19-3.82] was a significant predictor of END in patients with ischemic stroke. This association remained significant after controlling for confounders in multivariate logistic analysis. Multiple-adjusted spline regression model further confirmed the dose-response relationship between TMAO levels and END (P
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research

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This study aimed to investigate the associations of choline-related nutrients with cardiometabolic and all-cause mortality among black and white Americans and Chinese adults. METHODS: Included were 49,858 blacks, 23,766 whites, and 134,001 Chinese, aged 40-79 y, who participated in 3 prospective cohorts and lived ≥1 y after enrollment. Cox regression models were used to estimate HRs and 95% CIs for cardiometabolic [e.g., ischemic heart disease (IHD), stroke, and diabetes] and all-cause deaths. To account for multiple testing, P values 
Source: The American Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Am J Clin Nutr Source Type: research
Abstract The gut microbiome has been implicated in the progression of cardiovascular diseases (CVD) including hypertension, dyslipidemia, atherosclerosis, thrombosis, heart failure, and ischemic stroke. Metabolomics studies in humans and diverse mouse populations have revealed associations between diet-derived gut bacterial metabolites, including trimethylamine-N-oxide, short-chain fatty acids, and intermediates of aromatic amino acid breakdown, with progression of CVD. Functional studies in animals fed diets of defined composition have been instrumental for establishing causal links between these metabolites, the...
Source: Current Opinion in Microbiology - Category: Microbiology Authors: Tags: Curr Opin Microbiol Source Type: research
ConclusionsThis study demonstrated that increasing plasma level of TMAO may be associated with PSCI.
Source: Neurological Sciences - Category: Neurology Source Type: research
Abstract Trimethylamine N-oxide (TMAO) has emerged as a newly identified gut microbiota-dependent metabolite contributing to a variety of diseases, such as diabetes, atherosclerosis, and cardiovascular diseases. The aim of our study was to determine whether a relatively high TMAO level is associated with an increased risk of poor outcome in ischemic stroke patients. From June 2018 to December 2018, we prospectively recruited acute ischemic stroke patients diagnosed within 24 h of symptom onset. The plasma TMAO level was measured at admission for all patients. Functional outcome was evaluated at 3 months ...
Source: Cellular and Molecular Neurobiology - Category: Cytology Authors: Tags: Cell Mol Neurobiol Source Type: research
Geng-Hong Xia1†, Chao You1,2†, Xu-Xuan Gao1, Xiu-Li Zeng1, Jia-Jia Zhu1, Kai-Yu Xu3, Chu-Hong Tan1, Ruo-Ting Xu1, Qi-Heng Wu1, Hong-Wei Zhou3, Yan He4*‡ and Jia Yin1*‡ 1Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China 2Department of Neurology, The First People's Hospital of Zunyi, Zunyi, China 3State Key Laboratory of Organ Failure Research, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China 4Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical Univ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
In this study, we aim to answer the questions on whether component combination of berberine, baicalin, and geniposide (BBG), namely Refined-Huang-Lian-Jie-Du-Decoction, could achieve an efficacy less than, equal to, or better than the formula and whether unexpected effects, e.g., toxicity, occur due to this combination. This is important for the development of new drugs based on traditional therapies. Metabolomics is a thriving technology defined as the quantitative analysis of dynamic metabolic responses to pathophysiological stimuli or genetic modification (Nordström and Lewensohn, 2010; Baker, 2011). Metabolomics ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
The prescription of Sanhuang Xiexin is efficient and safe in the treatment of AIS patients after endovascular intervention examination through reducing the inflammatory factors. AbstractObjectivesTo explore the efficiency and safety of Sanhuang Xiexin decoction in the treatment of acute ischemic stroke (AIS) patients after endovascular intervention examination.MethodsIn this prospective observational study, 121 AIS patients admitted in our hospital were enrolled from January 2012 to December 2015. They were randomly divided into two groups, 61 patients received Sanhuang Xiexin decoction  + basic treatment (SX gro...
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Aim: In experimental studies gut microbiota-dependent metabolites, in particular trimethylamine N-oxide (TMAO), have recently been reported to promote atherosclerosis. Here, we examined for the first time the relation of TMAO with the severity of aortic atherosclerosis and the risk of incident cardiovascular events (CVE) in patients with recent first-ever ischemic stroke.
Source: Atherosclerosis - Category: Cardiology Authors: Source Type: research
r U Abstract OBJECTIVE: Gut microbiota-dependent metabolites, in particular trimethylamine N-oxide (TMAO), have recently been reported to promote atherosclerosis and thrombosis. Here, we examined for the first time the relation of TMAO and the risk of incident cardiovascular events in patients with recent first-ever ischemic stroke in 2 independent prospective cohorts. Moreover, the link between TMAO and proinflammatory monocytes as a potential contributing factor for cardiovascular risk in stroke patients was studied. APPROACH AND RESULTS: In a first study (n=78), higher TMAO plasma levels were linked with a...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
Atrial fibrillation (AF) is the most prevalent arrhythmia and is projected to rise from 2.7 –6.1 million in 2010 to 12.1 million by 2030 [1]. AF portends a 4–5 fold risk of ischemic stroke in non-anticoagulated patients, and is an independent risk factor for ischemic stroke severity, recurrence, and mortality [1]. Due to the alarming increase in global prevalence with the attached incr ease in morbidity, mortality, and cost there has been increased effort to identify risk factors in the hope that prevention would turn the tide of this disease [1,2].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
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