Mixed
Long-term elevated plasma TMAO levels are associated with a higher risk of incident atherosclerotic cardiovascular disease (ASCVD), but this association is significantly modified by renal function, being present only in individuals with impaired renal function (eGFR <60 mL/min/1.73 m2).
If you have impaired kidney function (eGFR <60), high TMAO levels are a significant warning sign for heart disease risk. If your kidney function is normal, high TMAO levels may not carry the same risk. Focus on maintaining kidney health and discussing TMAO testing with your doctor if you have known renal impairment.
High levels of TMAO were associated with higher incidence of ASCVD in the presence of impaired renal function (eGFR <60 mL/min per 1.73 m2: HR, 1.56 [95% CI, 1.13– 2.14]; P- trend=0.007), but not normal or mildly reduced renal function (eGFR ≥60 mL/min per 1.73 m2: HR, 1.03 [95% CI, 0.85– 1.25]; P- trend=0.668).
Why this rating
Large community-based prospective cohort (n=4131) with serial measures and central adjudication, though observational design prevents definitive causality.
Source
Longitudinal Plasma Measures of Trimethylamine N‐Oxide and Risk of Atherosclerotic Cardiovascular Disease Events in Community‐Based Older Adults
Yujin Lee et al. · Journal of the American Heart Association · 2021
DOI 10.1161/jaha.120.020646
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