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

• Published in: Clinical interventions in aging Vol. 15; pp. 1809 - 1820
• Main Authors: He, Wei, Luo, Yao, Liu, Jun-Peng, Sun, Ning, Guo, Di, Cui, Ling-Ling, Zheng, Pei-Pei, Yao, Si-Min, Yang, Jie-Fu, Wang, Hua
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Age; Aged; Aged, 80 and over; Aging; Alzheimer's disease; Biomarkers; Body mass index; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cognition Disorders - epidemiology; Cognitive ability; cognitive frailty; Cross-Sectional Studies; Diabetes; Ejection fraction; Female; Frail elderly; Frail Elderly - statistics & numerical data; Frailty; Gastrointestinal Microbiome - physiology; Geriatric Assessment; Geriatrics; Gut microbiota; Health aspects; Humans; Laboratories; Male; Metabolites; Methylamines - blood; Microbiota; Microbiota (Symbiotic organisms); Middle Aged; older adults; Older people; Original Research; physical frailty; Regression analysis; Risk Factors; Statistical analysis; tmao; China; Beijing China; TMAO; older adults; cardiovascular disease; frailty; physical frailty; cognitive frailty
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S270887

Our study aimed to explore the association between trimethylamine N-oxide and frailty in older adults with cardiovascular disease. 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. 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). Elevated circulating TMAO levels are independently associated with frailty among older adults with cardiovascular disease.