title: Intra-individual variation of plasma trimethylamine-N-oxide (TMAO), betaine and choline over 1 year.
abstract: BACKGROUND
  Circulating trimethylamine-N-oxide (TMAO) has been implicated in the development of cardiovascular and chronic kidney diseases (CKD). However, while higher TMAO levels have been associated with increased risks of cardiovascular or renal events in first prospective studies, it remained unclear how much plasma TMAO concentrations vary over time.
  
  
  METHODS
  We measured fasting plasma levels of TMAO and two of its precursors, betaine and choline by LC-MS, in two samples of 100 participants of the European Investigation into Cancer and Nutrition (EPIC)-Heidelberg study (age range: 47-80 years, 50% female) that were collected 1 year apart, and assessed their intra-individual variation by Spearman's correlation coefficients (ρ).
  
  
  RESULTS
  Correlations of metabolite concentrations over 1 year were at ρ=0.29 (p=0.003) for TMAO, ρ=0.81 (p<0.001) for betaine, and ρ=0.61 (p<0.001) for choline. Plasma levels of TMAO were not significantly associated with food intake, lifestyle factors, or routine biochemistry parameters such as C-reactive protein (CRP), low-density lipoprotein (LDL)-cholesterol, or creatinine.
  
  
  CONCLUSIONS
  In contrast to fasting plasma concentrations of betaine and choline, concentrations of TMAO were more strongly affected by intra-individual variation over 1 year in adults from the general population. The modest correlation of TMAO levels over time should be considered when interpreting associations between TMAO levels and disease endpoints.
authors.forename: Tilman
authors.initials: T
authors.lastname: Kühn
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: Disorn
authors.initials: D
authors.lastname: Sookthai
authors.forename: Theron
authors.initials: T
authors.lastname: Johnson
authors.forename: Verena
authors.initials: V
authors.lastname: Katzke
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Arnold
authors.initials: A
authors.lastname: von Eckardstein
authors.forename: Daniel
authors.initials: D
authors.lastname: Müller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001622:Betaine / Q000097:blood*; D002794:Choline / Q000097:blood*; D002853:Chromatography, Liquid; D005260:Female; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008744:Methylamines / Q000097:blood*; D008875:Middle Aged; D013997:Time Factors
chemical_list: D008744:Methylamines; D001622:Betaine; C005855:trimethyloxamine; D002794:Choline