High TMAO level was correlated with the increase of systolic blood pressure and pulse pressure, suggesting TMAO might be an influencing factor of blood pressure level, with no statistically significant correlation found between TMAO and blood glucose and lipid indicators.
Key Findings
Results
Serum TMAO levels showed significant positive correlations with systolic blood pressure (SBP) and pulse pressure (PP) in the overall study population.
Each 1 µmol/L increase in TMAO was associated with a 0.74 mmHg increase in SBP (95% CI: 0.19–1.30, P=0.009)
Each 1 µmol/L increase in TMAO was associated with a 0.64 mmHg increase in PP (95% CI: 0.21–1.08, P=0.004)
Analysis was performed using a linear mixed effects model to account for family clustering
Study population: 500 participants from 173 families, mean age 56.52±12.52 years, 54.20% male
Results
The association between TMAO and blood pressure markers was statistically significant in men but not in women.
In men, each 1 µmol/L increase in TMAO was associated with a 0.91 mmHg increase in SBP (95% CI: 0.24–1.57, P<0.05)
In men, each 1 µmol/L increase in TMAO was associated with a 0.85 mmHg increase in PP (95% CI: 0.37–1.35, P<0.05)
No significant correlation between TMAO and SBP or PP was found in women
These findings were derived from sex-stratified subgroup analyses
Results
The association between TMAO and blood pressure markers was statistically significant in participants aged ≥60 years but not in those aged <60 years.
In participants aged ≥60 years, each 1 µmol/L increase in TMAO was associated with a 1.10 mmHg increase in SBP (95% CI: 0.23–1.96, P<0.05)
In participants aged ≥60 years, each 1 µmol/L increase in TMAO was associated with a 0.98 mmHg increase in PP (95% CI: 0.23–1.73, P<0.05)
No significant correlation was found between TMAO and SBP or PP in participants aged <60 years
These findings were derived from age-stratified subgroup analyses
Results
No statistically significant correlation was found between serum TMAO levels and blood glucose or lipid indicators.
The study examined cardiovascular metabolic biomarkers including blood glucose and lipid indicators in addition to blood pressure
Despite significant associations with blood pressure, TMAO did not show significant correlations with glycemic or lipid markers
This finding was based on baseline data from the Beijing Fangshan Family Cohort collected from 2013 to 2017
Serum TMAO concentrations were measured using enzyme-linked immunosorbent assay (ELISA) kits
Methods
The study was based on baseline data from the Beijing Fangshan Family Cohort, using a family-based design with 500 participants from 173 families.
Data were collected from 2013 to 2017
The mean age of participants was 56.52±12.52 years, with 54.20% being male
A linear mixed effects model was used to analyze correlations, accounting for the nested family structure of the data
Serum TMAO was measured using enzyme-linked immunosorbent assay kits
What This Means
This research examined the relationship between blood levels of trimethylamine-N-oxide (TMAO) — a compound produced when gut bacteria break down certain nutrients found in red meat, fish, and eggs — and various markers of cardiovascular and metabolic health. The study analyzed data from 500 Chinese adults (average age about 57) who were part of a family-based health study in Beijing. Researchers found that higher TMAO levels were linked to higher systolic blood pressure (the top number in a blood pressure reading) and higher pulse pressure (the difference between the top and bottom numbers, which reflects arterial stiffness).
The associations were not uniform across all groups. The link between TMAO and blood pressure was statistically significant in men and in people aged 60 or older, but was not significant in women or in younger participants. Importantly, no significant relationship was found between TMAO and blood sugar or cholesterol/lipid levels, suggesting that TMAO's influence on cardiovascular risk may operate primarily through blood pressure pathways rather than metabolic ones like glucose or fat metabolism.
This research suggests that TMAO may be a contributing factor to elevated blood pressure, particularly in older adults and men. Since TMAO is shaped by diet and gut bacteria composition, these findings could have implications for understanding how dietary patterns influence cardiovascular risk. However, because this was a cross-sectional baseline analysis (a single point in time), it cannot prove that TMAO causes changes in blood pressure — further longitudinal and experimental studies would be needed to establish causation.
Zhang H, Peng H, Guo H, Hou T, Li Y, Zheng Y, et al.. (2026). [Correlation between trimethylamine-N-oxide and cardiovascular metabolic markers].. Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences. https://pubmed.ncbi.nlm.nih.gov/42880920/