Abstract | BACKGROUND: METHODS: This is a single-center, prospective cohort study from Xiamen, China. We examined the relationship between fasting TMAO and 2 of its nutrient precursors, choline and betaine, vs. 3-month functional outcome and mortality in 351 first-ever patients with acute ischemic stroke. RESULTS: The median value of the plasma level of TMAO was 6.1 μM (IQR, 3.7-9.9 μM), which was higher than in those control cases (4.0; 2.4-5.9 μM). Patients with a poor outcome and nonsurvivors had significantly increased TMAO levels on admission (P < 0.001). Following adjustments for traditional risk factors, increased TMAO concentrations remained predictive of both poor outcome and mortality risks in stroke patients [e.g., quartiles 4 vs 1, odd ratio 5.65 (95% CI, 2.87-13.45), P < 0.001; and 5.84 (95% CI, 3.05-16.12), P < 0.001, respectively]. In multivariate analysis, TMAO was an independent predictor of functional outcome and mortality and improved the prognostic accuracy of the NIHSS to predict functional outcome (combined areas under the curve, 0.82; 95% CI 0.77-0.89, P = 0.003) and mortality (combined areas under the curve, 0.85; 95% CI: 0.80-0.90, P = 0.002). CONCLUSIONS: Fasting plasma concentrations of gut microbial TMAO are higher in patients with ischemic stroke and portend higher poor functional outcome events and mortality.
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Authors | Jianli Zhang, Liankun Wang, Jinle Cai, Aidi Lei, Caiwen Liu, Ruidian Lin, Li Jia, Yingzi Fu |
Journal | Journal of neuroimmunology
(J Neuroimmunol)
Vol. 354
Pg. 577526
(05 15 2021)
ISSN: 1872-8421 [Electronic] Netherlands |
PMID | 33647820
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2021 Elsevier B.V. All rights reserved. |
Chemical References |
- Biomarkers
- Methylamines
- trimethyloxamine
- Choline
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Topics |
- Aged
- Biomarkers
(blood)
- China
- Choline
- Cohort Studies
- Female
- Gastrointestinal Microbiome
(physiology)
- Humans
- Ischemic Stroke
(blood)
- Male
- Methylamines
(blood)
- Middle Aged
- Prognosis
- Prospective Studies
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