Diseases and disorders associated with TMAO (Trimethylamine N-oxide):
⚠️ TMAO – Associated Diseases & Disorders
TMAO is a gut microbiota–derived metabolite with roles in lipid metabolism, cardiovascular health, and inflammation. Elevated levels are linked to a variety of chronic diseases.
🔹 1. Cardiovascular Disease (CVD)
Most strongly associated disease category.
✅ TMAO promotes:
- Atherosclerosis
- Endothelial dysfunction
- Platelet hyperreactivity → Thrombosis
📌 Mechanisms:
- Enhances foam cell formation
- Suppresses reverse cholesterol transport
- Increases vascular inflammation
🫀 Associated Conditions:
- Coronary artery disease (CAD)
- Myocardial infarction (heart attack)
- Stroke
- Peripheral artery disease (PAD)
🔹 2. Chronic Kidney Disease (CKD)
TMAO is renally excreted — so it accumulates in patients with impaired kidney function.
📉 Effects:
- Promotes renal fibrosis
- Enhances oxidative stress and inflammation
- Correlates with disease progression
🔹 3. Heart Failure
- Elevated TMAO levels are associated with increased mortality and hospitalization risk in patients with both HFpEF and HFrEF.
🔹 4. Type 2 Diabetes & Insulin Resistance
- TMAO affects glucose metabolism, insulin sensitivity, and pancreatic beta-cell function.
- Linked with:
- Inflammation
- Altered bile acid signaling
- Dysregulated lipid metabolism
🔹 5. Non-Alcoholic Fatty Liver Disease (NAFLD)
- TMAO is involved in hepatic fat accumulation, inflammation, and fibrogenesis.
🔹 6. Cognitive Decline / Alzheimer’s Disease (emerging link)
- TMAO detected in cerebrospinal fluid (CSF)
- May promote neuroinflammation and blood-brain barrier disruption
🧾 Summary Table
| Disease | TMAO-Linked Pathologies |
| Atherosclerosis / CVD | Promotes plaque formation, thrombosis, endothelial dysfunction |
| Chronic Kidney Disease (CKD) | Impaired excretion → accumulation, worsens renal damage |
| Heart Failure | Higher mortality and cardiac dysfunction |
| Type 2 Diabetes | Impairs insulin signaling, promotes inflammation |
| NAFLD / NASH | Liver steatosis and fibrosis |
| Neurodegenerative Diseases | Emerging evidence: cognitive decline, Alzheimer’s |