Title:Meta-analysis of the Impact of Bariatric Surgery on Circulating
TMAO Levels as a Predictor of Cardiovascular Disease Risk
Volume: 31
Issue: 24
Author(s): Tannaz Jamialahmadi, Luis E. Simental-Mendia, Gokhan Zengin, Wael Almahmeed, Prashant Kesharwani and Amirhossein Sahebkar*
Affiliation:
- Applied Biomedical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical
Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad
University of Medical Sciences, Mashhad, Iran
- School of Medicine, The University of Western Australia,
Perth, Australia
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences,
Mashhad, Iran
Keywords:
Gastric bypass, microbiome, cardiovascular disease, metabolic surgery, trimethylamine N-oxide, comprehensive meta-analysis.
Abstract:
Introduction: Trimethylamine N-oxide (TMAO) is a metabolite of the gut microbiota
that is considered a cardiovascular risk factor. Because bariatric surgery (BS)
produces changes in the composition of the gut microbiota, the production of TMAO can
be compromised. Thus, the purpose of this meta-analysis was to determine the effect of
BS on circulating TMAO levels.
Methods: A systematic search was carried on in Embase, PubMed, Web of Science, and
Scopus databases. The meta-analysis was conducted using Comprehensive Meta-Analysis
(CMA) V2 software. The overall effect size was determined by a random-effects metaanalysis
and the leave-one-out approach.
Results: Random-effects meta-analysis of 5 studies consisting of 142 subjects demonstrated
a significant increase in circulating TMAO levels after BS (SMD: 1.190, 95% CI:
0.521, 1.858, p<0.001; I2:89.30%).
Conclusion: Considering that levels of TMAO are affected after BS due to gut microbial
metabolism alteration, there has been a significant elevation in TMAO concentrations observed
to occur after BS in obese subjects.