Exp Clin Endocrinol Diabetes 2016; 124(04): 251-256
DOI: 10.1055/s-0035-1569330
© Georg Thieme Verlag KG Stuttgart · New York

Diabetes is Associated with Higher Trimethylamine N-oxide Plasma Levels

M. Dambrova
1   Latvian Institute of Organic Synthesis, Riga, Latvia
2   Riga Stradins University, Riga, Latvia
G. Latkovskis
3   Paul Stradins Clinical University Hospital, Riga, Latvia
4   University of Latvia, Riga, Latvia
5   Latvian Research Institute of Cardiology, Riga, Latvia
J. Kuka
1   Latvian Institute of Organic Synthesis, Riga, Latvia
I. Strele
2   Riga Stradins University, Riga, Latvia
I. Konrade
2   Riga Stradins University, Riga, Latvia
S. Grinberga
1   Latvian Institute of Organic Synthesis, Riga, Latvia
D. Hartmane
1   Latvian Institute of Organic Synthesis, Riga, Latvia
O Pugovics
1   Latvian Institute of Organic Synthesis, Riga, Latvia
A. Erglis
3   Paul Stradins Clinical University Hospital, Riga, Latvia
4   University of Latvia, Riga, Latvia
5   Latvian Research Institute of Cardiology, Riga, Latvia
E. Liepinsh
1   Latvian Institute of Organic Synthesis, Riga, Latvia
› Author Affiliations
Further Information

Publication History

received 16 November 2015
first decision 16 November 2015

accepted 18 November 2015

Publication Date:
28 April 2016 (online)


Recent studies have revealed strong associations between systemic trimethylamine N-oxide (TMAO) levels, atherosclerosis and cardiovascular risk. In addition, plasma L-carnitine levels in patients with high TMAO concentrations predicted an increased risk for cardiovascular disease and incident major adverse cardiac events. The aim of the present study was to investigate the relation between TMAO and L-carnitine plasma levels and diabetes. Blood plasma samples were collected from 12 and 20 weeks old db/db mice and patients undergoing percutaneous coronary intervention. Diabetic compared to non-diabetic db/L mice presented 10-fold higher TMAO, but lower L-carnitine plasma concentrations at 12 weeks of age. After 8 weeks of observation, diabetic db/db mice had significantly increased body weight, insulin resistance and TMAO concentration in comparison to non-diabetic control. In 191 patients undergoing percutaneous coronary intervention the median (interquartile range) plasma concentration of TMAO was 1.8 (1.2–2.6) µmol/L. Analysis of the samples showed a bivariate association of TMAO level with age, total cholesterol and L-carnitine. The multivariate linear regression analysis revealed that, in addition to L-carnitine as the strongest predictor of log transformed TMAO (p<0.001), the parameters of age, diabetes status and body mass index (BMI) were independently associated with increased log transformed TMAO levels (p<0.01).

Our data provide evidence that age, diabetes and BMI are associated with higher TMAO levels independently of L-carnitine. These data support the hypothesis of TMAO as a cardiovascular risk marker and warrant further investigation of TMAO for diabetes research applications.

Supplementary Material

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