| It has been suggested that trimethylamine N-oxide (TMAO) is associated with
increased risk of diabetes and cardiovascular disease (CVD) morbidity and mortality.
However, it is not known whether increased TMAO concentrations is associated with
obesity. In the current study, we summarized the evidence related to the association
of circulating TMAO with the risk of obesity measurements, including body mass
index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) in a two-class
and dose-response meta-analysis of observational studies. A systematic search carried
out in PubMed, SCOPUS, Cochrane, and ProQuest through September 30, 2019
resulted in 12 eligible studies which were included in the current meta-synthesis. In
these studies, BMI was reported but there were no reports of WC or WHR. Metaanalysis
of two-class variables and dose-response meta-analysis of continuous variables
were performed. Subgroup analysis and meta-regression were also performed
to identify the source of heterogeneity. There was a dose-response association
between circulating TMAO concentration and increased BMI in studies involving
healthy individuals (P nonlinearity = .007), while no evidence of departure from linearity
was observed according to study design or among patients with CVD. Results
showed the highest category of TMAO was associated with 0.56 kg/m2 increase in
BMI (weighted mean difference [WMD], 0.563; CI, 0.026-1.100; P = .04). The results
of the current meta-analysis revealed a positive association between circulating
TMAO and obesity as presented by increased BMI. Moreover, a dose-dependent
association between circulating TMAO and obesity was also identified in apparently
healthy individuals. This is the first meta-analysis to reveal positive dose-dependent
associations between circulating TMAO concentration and obesity. |