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Meta-analysis of the Impact of Bariatric Surgery on Circulating TMAO Levels as a Predictor of Cardiovascular Disease Risk


Tannaz Jamialahmadi, Luis E. Simental-Mendia, Gokhan Zengin, Wael Almahmeed, Prashant Kesharwani and Amirhossein Sahebkar*   Pages 1 - 7 ( 7 )


Introduction: Trimethylamine N-oxide (TMAO) is a metabolite of the gut microbiota that is considered a cardiovascular risk factor. Because bariatric surgery (BS) produces changes in the composition of the gut microbiota, the production of TMAO can be compromised. Thus, the purpose of this meta-analysis was to determine the effect of BS on circulating TMAO levels.

Methods: A systematic search was carried on in Embase, PubMed, Web of Science, and Scopus databases. The meta-analysis was conducted using Comprehensive Meta-Analysis (CMA) V2 software. The overall effect size was determined by a random-effects metaanalysis and the leave-one-out approach.

Results: Random-effects meta-analysis of 5 studies consisting of 142 subjects demonstrated a significant increase in circulating TMAO levels after BS (SMD: 1.190, 95% CI: 0.521, 1.858, p<0.001; I2:89.30%).

Conclusion: Considering that levels of TMAO are affected after BS due to gut microbial metabolism alteration, there has been a significant elevation in TMAO concentrations observed to occur after BS in obese subjects.


Gastric bypass, microbiome, cardiovascular disease, metabolic surgery, trimethylamine N-oxide, comprehensive meta-analysis.


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