Study investigates TMAO and carotid intima-media thickness as markers of metabolic dysfunction in obesity, suggesting implications for cardiovascular risk assessment.
Background/Introduction Obesity in both children and adults is closely linked to increased cardiometabolic risk and early vascular impairment, including subclinical atherosclerosis. Identifying early markers of such dysfunction is critical for timely intervention. Trimethylamine N-oxide (TMAO), a gut-derived metabolite implicated in cardiometabolic diseases, has emerged as a potential biomarker of vascular and metabolic risk. Purpose This study aimed to investigate the association of TMAO levels with carotid intima-media thickness (CIMT) and other metabolic markers in obese pediatric and adult populations, assessing its potential as an early indicator of cardiometabolic dysfunction. Methods Seventy children (aged 4–18 years) and sixty adults (aged 18–71 years) with varying degrees of adiposity were evaluated. Assessments included anthropometric data, blood pressure, HOMA-IR, lipid profile, and TMAO levels. CIMT was measured using the Aixplorer MACH 30 ultrasound system. Results In children, obese participants had significantly elevated TMAO levels, which correlated positively with BMI, waist circumference, CIMT, and blood pressure. TMAO was an independent predictor of CIMT after adjusting for BMI, pubertal stage, and age. While no significant association was found between TMAO and HOMA-IR, TMAO levels negatively correlated with fasting glucose and were linked to the presence of acanthosis nigricans. In adults, TMAO showed a strong correlation with CIMT and moderate associations with BMI, waist circumference, trunk fat percentage, LDL cholesterol, and HOMA- IR. Waist circumference, trunk fat percentage, CIMT, and smoking status were significant predictors of TMAO levels. Both TMAO and CIMT increased with age. Conclusion(s) TMAO serves as a marker of vascular and metabolic dysfunction across age groups, independently predicting CIMT beyond traditional risk factors. Its role in early cardiovascular risk stratification in pediatric and adult obesity supports further research and highlights its potential as a therapeutic target.
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Mihuta et al. (2025) studied this question.