Increased Serum Trimethylamine N-Oxide Level in Type 2 Diabetic Patients with Mild Cognitive Impairment

Nongzhang Xu; Jianwei Wan; Cuihong Wang; Jiatao Liu; Chenqai Qian; Hongyang Tan

doi:10.2147/DMSO.S370206

Increased Serum Trimethylamine N-Oxide Level in Type 2 Diabetic Patients with Mild Cognitive Impairment

Diabetes Metab Syndr Obes. 2022 Jul 28:15:2197-2205. doi: 10.2147/DMSO.S370206. eCollection 2022.

Authors

Nongzhang Xu^#¹, Jianwei Wan^#¹, Cuihong Wang¹, Jiatao Liu², Chenqai Qian¹, Hongyang Tan³

Affiliations

¹ Department of Pharmacy, Shanghai University of Medicine and Health Science Affiliated Zhoupu Hospital, Shanghai, People's Republic of China.
² Department of Oncology, the First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
³ Clinical Research Center for Mental Disorders, Chinese-German Institute of Mental Health Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Trimethylamine N-oxide (TMAO) is a metabolite of phosphatidylcholine in red meat and other diets, which is associated with cardiovascular and other diseases. The aim of this study is to evaluate the associations of serum TMAO with mild cognitive impairment (MCI) in the Chinese type 2 diabetes mellitus (T2DM) population.

Materials and methods: A total of 253 hospitalized T2DM patients and 150 healthy controls were included in this cross-sectional study. Montreal Cognitive Assessment (MoCA) assessed the cognition function, and the 253 T2DM patients were divided into 74 subjects with MCI and 179 with non-MCI. Demographic data and biochemical test results were evaluated. Serum TMAO level was measured by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS).

Results: A higher serum TMAO level was observed in T2DM patients compared with the healthy controls (P < 0.001). Among all T2DM patients, the MCI group (n = 74) showed higher serum TMAO levels than the non-MCI group. Spearman correlation test showed that TMAO levels were significantly positively correlated with age (r = 0.147, P = 0.019), body mass index (BMI) (r = 0.153, P = 0.015), diabetes duration (r = 0.160, P = 0.011), HbA1c (r = 0.138, P = 0.029), triglyceride (TG) (r = 0.138, P = 0.029), creatinine (r = 0.184, p = 0.003), hs-CRP (r = 0.243, P < 0.001), and were negatively correlated with HDL-C (r = -0.144, P = 0.022), BDNF (r = -0.165, p = 0.009), and MoCA (r = -0.386, P < 0.001) score (all P < 0.05). Multivariable Logistic regression identified high serum TMAO level as a significant independent factor of MCI in the T2DM patients (OR = 1.404, 95% CI = 1.255-1.571; P < 0.001).

Conclusion: Our study showed that T2DM patients with MCI have elevated serum TMAO levels.

Keywords: Montreal Cognitive Assessment; healthy control; mild cognitive impairment; trimethylamine N-oxide; type 2 diabetes mellitus.

Grants and funding

The work was supported by The work was supported by 1) Health plan scientific research project of Shanghai Pudong New Area Health Committee (pw2020A-63); 2)The Outstanding Clinical Discipline Project of Shanghai Pudong (Grant No. : PWYgy2021-02).