20. SERUM GUT-DERIVED METABOLITE TRIMETHYLAMINE N-OXIDE CONCENTRATION IS ASSOCIATED WITH RISK OF PRE-ECLAMPSIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

• Published in: Journal of hypertension Vol. 39; no. Supplement 2; p. e5
• Main Authors: Kamarullah, William, Angelina, Monica, Suratinoyo, Adis Tiara
• Format: Journal Article
• Language: English
• Published: 01-05-2021
• ISSN: 0263-6352; 1473-5598
• DOI: 10.1097/01.hjh.0000752428.02236.ad

Background: The gut microbial metabolite trimethylamine N-oxide (TMAO) is gradually deemed as a novel risk factor for cardiovascular events. However, there is limited evidence about the role of TMAO in pre-eclampsia. Objective: The aim of this systematic review and meta-analysis is to assess the association of TMAO in pre-eclampsia. Methods: PubMed, Europe PMC, ProQuest, EBSCOhost, and Google Scholar were systematically searched from inception up to January 2021. The standardized mean difference (SMD) with 95% confidence interval (CI) were estimated and pooled to investigate the effect sizes. Results: Three eligible articles that met the study criteria were included in the current meta-analysis. Overall, the higher serum TMAO level was significantly associated with risk for pre-eclampsia (SMD = 0.87, 95% confidence interval [CI] = 0.29–1.46, Z = 2.94, P = 0.003) compared with healthy control. A significant heterogeneity among studies was observed ( I 2 = 85%; P -heterogeneity = 0.001). Hence, we conducted subgroup analyses of severity status to investigate the source of heterogeneity. Consistent results were obtained in all examined subgroups as well as in the sensitivity analysis. The risk for severe pre-eclampsia for higher serum TMAO was 1.16 (95% CI = 0.69–1.62, Z = 4.85, P < 0.00001) compared with control group although no significant difference was observed concerning the association between serum TMAO level and mild pre-eclampsia (SMD = 0.44, 95% CI = 0.27–1.15, Z = 1.21, P = 0.22). Conclusion: The current meta-analysis shows that higher serum TMAO amount was associated with increased risk of pre-eclampsia.