Evidence map›Paper›PMID 42778937›Full record

ArticleNutrition & metabolism2026

Trimethylamine N-oxide and major adverse cardiac and cerebrovascular events: results of umbrella review and meta-analysis.

Rima Obeid, Lorenz Mohr, Bryan A White, Gunnar H Heine, Insa Emrich, Juergen Geisel, R Colin Carter

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Article in Nutrition & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rima ObeidDepartment of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Homburg/Saar, Germany. rima.obeid@uks.eu.
Lorenz MohrDepartment of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Homburg/Saar, Germany.
Bryan A WhiteDepartment of Animal Sciences and Fellow American Academy of Microbiology, University of Illinois, 1207 W. Gregory Drive, Urbana, Il, 6180, USA.
Gunnar H HeineAgaplesion Markus Hospital, Medical Clinic II, Wilhelm-Epstein Straße 4, D-60431, Frankfurt am Main, Germany.
Insa EmrichDepartment of Internal Medicine III, Cardiology, Angiology, and Intensive Care Medicine, Saarland University Medical Center, Homburg, Germany.
Juergen GeiselDepartment of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Homburg/Saar, Germany.
R Colin CarterDepartments of Pediatrics and Emergency Medicine and the Institute of Human Nutrition, Columbia University Irving Medical Center, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCirculating trimethylamine N-oxide (TMAO) may be a causal factor or marker for major adverse cardiac and cerebrovascular events (MACE), but evidence in humans is limited to observational studies with inherent uncertainties.

methodsWe conducted an umbrella systematic review and meta-analysis of human studies. The search in MEDLINE, Web of Science, Cochrane Library and PROSPERO (last updated in February 2025) identified 120 publications that met our inclusion criteria.

resultsThe pooled hazard ratio (HR) and 95% confidence intervals (95%CIs) from 34 cohort studies on TMAO and MACE = 1.20 (1.12-1.27), the prediction interval (PI) was 0.93-1.54, and I

conclusionsPreviously reported association estimates between TMAO and MACE in human studies are systematically overestimated. The results do not support TMAO being a causal factor or marker of MACE and related conditions. Harmonisation of TMAO measurements between labs and cohort studies in healthy people that address confounding factors remain critically needed.

Indexed as

Cardiovascular diseaseGut-bacteriaMetabolismRenal functionRisk factorsStrokeTrimethylamine N-oxide

Identifiers

PMID42778937
PMCPMC13599251

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.