Meta-analysis of the impact of bariatric surgery on circulating TMAO levels as a predictor of cardiovascular disease risk

Tannaz Jamialahmadi; Luis E Simental-Mendia; Gokhan Zengin; Wael Almahmeed; Prashant Kesharwani; Amirhossein Sahebkar

doi:10.2174/0929867330666230523155750

Meta-analysis of the impact of bariatric surgery on circulating TMAO levels as a predictor of cardiovascular disease risk

Curr Med Chem. 2023 May 23. doi: 10.2174/0929867330666230523155750. Online ahead of print.

Authors

Tannaz Jamialahmadi^{1

2}, Luis E Simental-Mendia³, Gokhan Zengin⁴, Wael Almahmeed⁵, Prashant Kesharwani^{6

7}, Amirhossein Sahebkar^{2

8

9

10}

Affiliations

¹ Surgical Oncology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
² Applied Biomedical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
³ Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.
⁴ Department of Biology, Science Faculty, Selcuk University, Konya 42130, Turkey.
⁵ Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
⁶ Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.
⁷ Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Chennai, India.
⁸ Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
⁹ School of Medicine, The University of Western Australia, Perth, Australia.
¹⁰ Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

PMID: 37226793
DOI: 10.2174/0929867330666230523155750

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 meta-analysis 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.

Keywords: Cardiovascular disease; Comprehensive Meta-Analysis; Gastric bypass; Metabolic surgery; Microbiome; Trimethylamine N-oxide.

Publication types

Meta-Analysis