Neighborhood Environment Associates with Trimethylamine-N-Oxide (TMAO) as a Cardiovascular Risk Marker

Background: Neighborhoods and the microbiome are linked to cardiovascular disease (CVD), yet investigations to identify microbiome-related factors at neighborhood levels have not been widely investigated. We sought to explore relationships between neighborhood deprivation index (NDI) and the microbial metabolite, trimethylamine-N-oxide. We hypothesized that inflammatory markers and dietary intake would be mediators of the relationship. Methods: African-American adults at risk for CVD living in the Washington, DC area were recruited to participate in a cross-sectional community-based study. US census-based neighborhood deprivation index (NDI) measures (at the census-tract level) were determined. Serum samples were analyzed for CVD risk factors, cytokines, and the microbial metabolite, trimethylamine-N-oxide (TMAO). Self-reported dietary intake based on food groups was collected. Results: Study participants (n = 60) were predominantly female (93.3%), with a mean (SD) age of 60.83 (+/-10.52) years. Mean (SD) NDI was -1.54 (2.94), and mean (SD) TMAO level was 4.99 (9.65) mu mol/L. Adjusting for CVD risk factors and BMI, NDI was positively associated with TMAO (beta = 0.31, p = 0.02). Using mediation analysis, the relationship between NDI and TMAO was significantly mediated by TNF-alpha (60.15%) and interleukin)-1 beta (IL; 49.96%). When controlling for clustering within neighborhoods, the NDI-TMAO association was no longer significant (beta = 5.11, p = 0.11). However, the association between NDI and IL-1 beta (beta = 0.04, p = 0.004) and TNF-alpha (beta = 0.17, p = 0.003) remained. Neither NDI nor TMAO was significantly associated with daily dietary intake. Conclusion and Relevance: Among a small sample of African-American adults at risk for CVD, there was a significant positive relationship with NDI and TMAO mediated by inflammation. These hypothesis-generating results are initial and need to be confirmed in larger studies.

Automated summary

This study revealed a significant positive relationship between neighborhood deprivation index (NDI) and the microbial metabolite trimethylamine-N-oxide (TMAO) mediated by inflammation in African-American adults at risk for cardiovascular disease (CVD). Inflammatory markers TNF-α and IL-1 beta were found to mediate this relationship. The associations suggest potential links between neighborhood environment, microbiome, and CVD risk that warrant further investigation in larger studies.