Chronic constipation was associated with higher mean serum TMAO levels compared to healthy controls (9.0 vs 1.8 µM; p<0.01), which significantly decreased to 4.5 µM after 12 weeks of treatment.
Observational (n=237)
Yes
Does treatment with magnesium oxide or elobixibat reduce serum TMAO levels in patients with chronic constipation?
237 participants including 72 healthy controls and 165 patients with chronic constipation (110 normal transit constipation, 55 slow-transit constipation) from three Japanese centers.
Treatment with magnesium oxide (MgO) or elobixibat for 12 weeks
Healthy controls (for baseline comparison) and pre-treatment baseline levels
Serum TMAO levels at baseline, 4 weeks, and 12 weekssurrogate
Chronic constipation is associated with elevated serum TMAO, a cardiovascular risk marker, which can be significantly reduced with laxative treatments like elobixibat or magnesium oxide.
Absolute Event Rate: 9% vs 1.8%
p-value: p=<0.01
BACKGROUND: Chronic constipation (CC) is associated with increased cardiovascular events, and trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite, has been recently shown to correlate with this risk. We examined how constipation status affects serum TMAO and how treatment modifies it. METHODS: This prospective observational study (July 2023-September 2024), conducted at three Japanese centers. Healthy controls (HCs) were recruited during health checkups, and patients with CC recruited from outpatient clinics. Serum TMAO was measured using liquid chromatography-tandem mass spectrometry at baseline and at 4 and 12 weeks after treatment with magnesium oxide (MgO) or elobixibat. CC was classified as normal transit constipation (NTC) or slow-transit constipation (STC) by colonic transit time. RESULTS: Overall, 72 HCs and 165 patients with CC (NTC, n = 110; STC, n = 55) were included. Mean serum TMAO levels were 1.8 ± 1.1 µM and 9.0 ± 8.1 µM in the HC and CC groups, respectively (p<0.01). Serum TMAO levels were significantly higher in the STC group than in the NTC group (p<0.01). Constipation treatment reduced serum TMAO levels to 5.5 ± 7.6 µM (n = 165, p<0.01) at 4weeks and 4.5 ± 7.6 µM (n = 165, p<0.01) at 12 weeks. Elobixibat lowered serum TMAO at 4 and 12 weeks in both NTC and STC. Conversely, MgO lowered TMAO only at 12 weeks in NTC and did not affect STC. CONCLUSIONS: Constipation status, particularly STC, is associated with elevated serum TMAO levels. MgO or elobixibat significantly reduced serum TMAO, with a greater reduction observed with elobixibat.
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Yo Ishihara
International University of Health and Welfare
Eikichi Ihara
Kyushu University
Hidenori Ohkubo
National Sagamihara Hospital
Kyushu University
Yokohama City University
Shimane University
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Ishihara et al. (Thu,) conducted a observational in Chronic constipation (n=237). Magnesium oxide or elobixibat vs. Healthy controls (baseline) / Pre-treatment (follow-up) was evaluated on Mean serum TMAO levels (p=<0.01). Chronic constipation was associated with higher mean serum TMAO levels compared to healthy controls (9.0 vs 1.8 µM; p<0.01), which significantly decreased to 4.5 µM after 12 weeks of treatment.
synapsesocial.com/papers/69f594e171405d493afffcef — DOI: https://doi.org/10.14309/ctg.0000000000001046
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