New blood test to assess heart attack and stroke risk

Trimethylamine-N-oxide

Trimethylamine-N-oxide is produced by the metabolism by the digestion of eggs, meat, milk, dairy, liver, shellfish and fish, by intetinal microbiota of omnivores. Carnitine and lecithin are metabolized and the end result is TMAO (trimethylamine-N-oxide).

(Researchers at Cleveland Clinic under the direction of
Stanley Hazen, which included Tang,[21] Koeth,[22] and
Wang,[23] studied the metabolism of lecithin and carnitine
found in eggs, meat, milk and diary products, liver, shellfish,
and fish. The intestinal microbiota of omnivores metabolizes
these substances producing trimethylamine oxide
(TMAO), which causes vascular injury. This investigation
was a powerful validation for WFPBN because ingestion of
these animal foods by persons who strictly consume plants
produces no TMAO. In fact, plant eaters do not have intestinal
bacteria capable of producing TMAO.

A new blood test can now detect trimethylamine-N-oxide.

The new test — now available through Cleveland HeartLab — measures blood levels of TMAO, a compound produced by the liver after intestinal bacteria digest certain nutrients: L-carnitine (found in red meat) and lecithin (found in egg yolks, meats and full-fat dairy products). Lecithin is also pumped into the intestines as a component of bile, so all individuals, regardless of diet, feed their gut microbes lecithin and have potential for elevated levels of TMAO.

“The higher someone’s level of TMAO is, the more susceptible that person is to accumulation of cholesterol in the artery wall. This increases the risk of a heart attack or stroke,” reports Stanley Hazen, MD, PhD., Vice Chair of Translational Research at the Lerner Research Institute.

Higher levels of trimethylamine-N-oxide are associated with higher risk of heart attack and stroke. This can be an early indicator of risk.

References

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1. http://www.jgc301.com/ch/reader/create_pdf.aspx?file_no=S_20170301008&flag=1
2. http://www.clevelandheartlab.com/blog/horizons-tmao-testing-a-new-way-to-assess-heart-attack-and-stroke-risk/