THE ASSOCIATION OF PLASMA TRIMETHYLAMINE N-OXIDE IN INDIAN PATIENTS WITH CORONARY ARTERY DISEASE WITH OR WITHOUT TYPE 2 DIABETES MELLITUS: A PROSPECTIVE COHORT STUDY

Background: The role of trimethylamine-N-oxide (TMAO) in the development of coronary artery disease (CAD) remains controversial, and prospective data are few. We aimed to investigate the association between plasma TMAO in CAD with or without diabetes mellitus (DM). Methods: This study was based on the community-based prospective cohort study in India. A total of 50 CAD, 50 CAD with DM patients and 50 healthy individuals aged 18-75 years were included from 2020 to 2022. CAD and DM was ascertained during follow-up visits. After getting written informed consent, the demographic characteristics, clinical profile, detailed nutrition history, laboratory investigations were collected from the patients. The blood samples of4 ml was collected from study participants and the samples were processed to measure plasma concentration of TMAO using Triple Quadrupole LC/MS/MS with online electrospray ionization tandem mass spectrometry. Results: CAD patients had significantly higher plasma levels of TMAO than control controls (1.100.83 µM vs. 2.040.61 µM). Moreover, there was no statistically significant difference in the plasma levels of TMAO between CAD-T2DM patients and control subjects (1.351.81 µM vs. 1.100.83 µM). Similarly, chronic consumption of red meat, fish, egg and dairy products raised plasma TMAO levels in individuals with CAD and CAD-DM in comparison with individuals who do not eat red meat (CAD: 2.100.60 vs. 1.680.65 µM vs. 1.090.88 vs. 0.480.10 µM). Conclusion: This is the first prospective study to evaluate the plasma levels of TMAO in CAD patients in the Indian population. TMAO was found to be substantially higher in patients with CAD and red meat consumers when compared to controls and no red meat consuming participants. However, there was no significant impact of diabetes on the concentration of TMAO.