Increased Circulating Trimethylamine N-Oxide, A Gut-Flora-Dependent Metabolite Of Choline And Betaine In Nonalcoholic Fatty Liver Disease Is Associated With High Serum Bile Acids

ObjectiveTrimethylamine-N-oxide (TMAO) is a gut-flora-dependent metabolite of choline and betaine and could dysregulate the bile acids (BAs) metabolism. Many study suggested that elevated circulating TMAO contributes to the risk of cardiovascular diseases, but little is known for non-alcoholic fatty liver disease (NAFLD). Evidence has linked that elevated circulating bile acids (BAs) level was detrimental to the fatty liver. The pathological mechanisms of TMAO on NAFLD via bile acids are not fully understood. Herein, we examined the association of circulating TMAO, BAs, choline and betaine with the presence and severity of NAFLD in Chinese adults. We also explored correlation of TMAO and BAs and the mRNA expression of bile acid metabolic enzyme. MethodsWe performed a hospital-based case-control study. We recruited 60 biopsy-proven NAFLD cases and 35 controls (18–60 years) and determined serum concentrations of TMAO, BAs, choline and betaine by high-performance liquid chromatography with online electrospra...