Unaccounted risk of cardiovascular disease: the role of the microbiome in lipid metabolism

Curr Opin Lipidol. 2019 Apr;30(2):125-133. doi: 10.1097/MOL.0000000000000582.

Abstract

Purpose of review: Not all of the risk of cardiovascular disease can be explained by diet and genetics, and the human microbiome, which lies at the interface of these two factors, may help explain some of the unaccounted risk. This review examines some of the well established links between the microbiome and cardiovascular health, and proposes relatively unexplored associations.

Recent findings: Byproducts of microbial metabolism are associated with health and disease: Trimethylamine N oxide is associated with atherosclerosis; whereas short-chain fatty acids are associated with decreased inflammation and increased energy expenditure. More broadly, a large number of association studies have been conducted to explore the connections between bacterial taxa and metabolic syndrome. In contrast, the relationship between the microbiome and triglycerides levels remains poorly understood.

Summary: We suggest that deeper understanding of the molecular mechanisms that drive linkages between the microbiome and disease can be determined by replacing 16S rRNA gene sequencing with shotgun metagenomic sequencing or other functional approaches. Furthermore, to ensure translatability and reproducibility of research findings, a combination of multiple different complementary '-omic' approaches should be employed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Atherosclerosis / genetics
  • Atherosclerosis / immunology
  • Atherosclerosis / microbiology*
  • Atherosclerosis / pathology
  • Bile Acids and Salts / immunology
  • Bile Acids and Salts / metabolism
  • Carnitine / immunology
  • Carnitine / metabolism
  • Choline / immunology
  • Choline / metabolism
  • Energy Metabolism / genetics
  • Energy Metabolism / immunology
  • Fatty Acids, Volatile / immunology
  • Fatty Acids, Volatile / metabolism*
  • Gastrointestinal Microbiome / genetics
  • Gastrointestinal Microbiome / immunology*
  • Genomics / methods
  • High-Throughput Nucleotide Sequencing / methods
  • Humans
  • Lipid Metabolism / genetics
  • Lipid Metabolism / immunology*
  • Metabolic Syndrome / genetics
  • Metabolic Syndrome / immunology
  • Metabolic Syndrome / microbiology*
  • Metabolic Syndrome / pathology
  • Methylamines / immunology
  • Methylamines / metabolism*
  • Methylamines / pharmacology
  • Phosphatidylcholines / immunology
  • Phosphatidylcholines / metabolism
  • RNA, Ribosomal, 16S / genetics
  • T-Lymphocytes, Helper-Inducer / drug effects
  • T-Lymphocytes, Helper-Inducer / immunology
  • T-Lymphocytes, Helper-Inducer / microbiology
  • Triglycerides / immunology
  • Triglycerides / metabolism

Substances

  • Bile Acids and Salts
  • Fatty Acids, Volatile
  • Methylamines
  • Phosphatidylcholines
  • RNA, Ribosomal, 16S
  • Triglycerides
  • trimethyloxamine
  • Choline
  • Carnitine