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Association between Levels of Trimethylamine N-Oxide and Cancer: A Systematic Review and Meta-Analysis

, , , ORCID Icon &
Pages 402-414 | Received 13 Jun 2022, Accepted 21 Sep 2022, Published online: 10 Oct 2022
 

Abstract

Cancer is the second leading cause of death in the world. Reports on the effect of Trimethylamine-N-oxide (TAMO), a small amine oxide generated by gut microbial metabolism of choline, betaine, and carnitine, on cancer are inconsistent. Therefore, this systematic review and meta-analysis summarize the effect of TAMO on cancer incidence. A systematic search was conducted in PubMed, Scopus, Web of Science, and Embase. Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). The pooled results of 16 studies, including 5930 participants, showed that the association between TMAO levels and cancer incidence is insignificant (Odds Ratio: 0.97, 95% CI: (0.64, 1.46), P-value = 0.871). Subgroup analysis showed that urinary TMAO levels were negatively associated with cancer incidence; in contrast, a direct and positive association was observed between serum TMAO levels and cancer incidence. However, “gender” and the “TMAO measuring method” were the potential sources of discrepancies. Meta-regression analysis did not reveal any significant association between duration of studies, age, female ratio, subjects-control, and subjects-case. The present study demonstrates that serum TAMO levels were insignificantly associated with cancer incidence.

Acknowledgments

This paper was derived from the research project approvedand financed by Student Research Committee, Kerman University of Medical Sciences, under no 400000675.

Author Contributions

Conceptualization, A.KH, and MH; methodology, MH, and A.KH; validation, FV; formal analysis, VM; investigation, ZA; resources, VM; data curation, A.KH.; writing—original draft preparation, MH and VM, and ZA; writing—review and editing, FV; visualization, A.KH., and MH; supervision, MH; project administration, A.KH.; All authors have read and agreed to the published version of the manuscript.

Disclosure Statement

No potential conflict of interest was reported by the authors.

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