Gut Microbiota Metabolite TMAO and Adolescent Cardiometabolic Health

Fernando de Quadros Iorra, Paula Godinho Rodrigues, Patrícia Martins Bock, Marina Petrasi Guahnon, Sarah Eller, Tiago Franco de Oliveira, Leticia Birk, Patricia de Souza Schwarz, Michele Drehmer, Katia V Bloch, Felipe Vogt Cureau, Beatriz D Schaan
Journal of the Endocrine Society, Volume 9, Issue 5, May 2025, bvaf055
https://doi.org/10.1210/jendso/bvaf055

Abstract

Background

Trimethylamine N-oxide (TMAO) is a metabolite derived from gut microbiota that has been associated with cardiovascular and metabolic disease risk in adults. However, its role in assessing cardiometabolic risk in adolescents is unclear.

Objective

This study investigates the association between serum TMAO levels and cardiometabolic health indicators in Brazilian adolescents.

Materials and Methods

This is a multicenter, cross-sectional analysis involving 4446 participants aged 12 to 17 years from four Brazilian cities. Serum TMAO levels were quantified using liquid chromatography-tandem mass spectrometry, and associations with clinical, metabolic, and inflammatory variables were evaluated through multivariate linear regression analyses.

Results

After adjusting for potential confounders, being in the highest tertile of serum TMAO was positively associated with waist circumference [β 1.45; 95% confidence interval (CI) 0.77, 2.14; P < .001], body mass index Z-score (β .19; 95% CI 0.10, 0.27; P < .001), and C-reactive protein (β .24; 95% CI 0.13, 0.34; P < .001). A negative association between the highest tertile of TMAO and fasting plasma glucose was also observed (β −1.22; 95% CI −1.77, −0.66; P < .001).

Conclusion

TMAO may serve as an emerging biomarker for cardiometabolic risk assessment in adolescents.

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