Association of trimethylamine N-oxide and metabolites with kidney function decline in patients with chronic kidney disease.

Trimethylamine N-oxide (TMAO) is a gut microbial metabolite derived from dietary l-carnitine and choline. High plasma TMAO levels are associated with cardiovascular disease and overall mortality, but little is known about the associations of TMAO and related metabolites with the risk of kidney function decline among patients with chronic kidney disease (CKD). We prospectively followed 152 nondialysis patients with CKD stages 3-5 and measured plasma TMAO and related metabolites (trimethylamine [TMA], choline, carnitine, and γ-butyrobetaine) via liquid chromatography‒mass spectrometry. An estimated glomerular filtration rate (eGFR) slope >3 ml/min/per 1.73 m2 per year was defined as a rapid decline. We performed logistic regression to determine the probability of rapid or slow eGFR decline, with each metabolite as the main predictor. The gut microbiota was profiled via whole metagenomic sequencing. The participants had a median age of 66 years, 41.4 % were women, 39.5 % had diabetes, and the median eGFR was 23 mL/min/1.73 m2. A rapid decrease in the eGFR occurred in 65 patients (42.8 %) over a median follow-up of 3.3 years. After adjustment for baseline eGFR, proteinuria, and clinical factors, plasma TMAO levels were independently associated with increased odds of rapid eGFR decline (odds ratio, 2.42; 95 % CI, 1.36-4.32), whereas plasma TMA, choline, carnitine, and γ-butyrobetaine levels were not. Patients who exhibited rapid eGFR decline had a distinct gut microbial composition characterized by increased α-diversity and an abundance of TMA-producing bacteria, including those of the genera Desulfovibrio and Collinsella tanakaei, as well as increased expression of the TMA-producing enzymes bbuA and cutC. Our findings suggest the relevance of plasma TMAO in the progression of kidney disease among patients with CKD.

被引量：- 发表：1970

Emerging EAT-Lancet planetary health diet is associated with major cardiovascular diseases and all-cause mortality: A global systematic review and meta-analysis.

In 2019, the EAT-Lancet Commission promoted a plant-based diet, emphasizing its potential to enhance human health and environmental sustainability. Nevertheless, a thorough evaluation of health benefits associated with EAT-Lancet diet requires robust statistical backing. This synthesis seeks to compile evidence related to the effects of the EAT-Lancet diet on major cardiovascular disease (CVD) and mortality. A systematic review and meta-analysis were conducted utilizing data from MEDLINE, EMBASE, PubMed, Web of Science, and medRxiv, covering the period from January 2019 to October 8, 2024. We included all cohort and case-control studies that investigated the association between the emerging EAT-Lancet diet and outcomes such as diabetes, CVD, all-cause mortality, and cancer. Summary effect size estimates are presented as hazard ratios (HRs) and were analyzed using random-effects models. Study heterogeneity was assessed with the Q statistic and I2 statistic. Subgroup analyses were performed to identify potential sources of variability, while publication bias was evaluated using Begg's and Egger's tests. Additionally, sensitivity analyses were conducted to assess the robustness of the results. We identified 28 publications that included a total of over 2.21 million participants. Adhering to the EAT-Lancet dietary patterns was negatively associated with diabetes, CVD (mortality), all-cause mortality, and cancer (mortality), with HRs of 0.78 (95 % CI: 0.65-0.92), 0.84 (95 % CI: 0.81-0.87), 0.83 (95 % CI: 0.78-0.89), and 0.86 (95 % CI: 0.80-0.92), respectively. Significant heterogeneity was observed for diabetes (I2 = 94.0 %), all-cause mortality (I2 = 85.5 %), and cancer incidence (I2 = 79.3 %). Importantly, no evidence of publication bias was found for any of the clinical outcomes analyzed. Sensitivity analyses confirmed the robustness of the results across various dietary scoring systems for CVD mortality, all-cause mortality, and cancer. Following the EAT-Lancet diet was significantly associated with reduced odds of diabetes, CVD, cancer and mortality. These findings are clinically important, highlighting the beneficial effects of the recent EAT-Lancet diet on various health outcomes.

被引量：- 发表：1970

The effect of post-oral bitter compound interventions on the postprandial glycemia response: A systematic review and meta-analysis of randomised controlled trials.

被引量：- 发表：1970

Lipidomic perturbations of normal-weight adiposity phenotypes and their mediations on diet-adiposity associations.

被引量：- 发表：1970

Metabolic phenotypes and vitamin D response in the critically ill: A metabolomic cohort study.

被引量：- 发表：1970