High serum and urine concentrations of TMAO, produced from intestinal microbial metabolism of phosphatidylcholine, may increase an individual’s susceptibility to adverse cardiac events and cardiovascular diseases.

This study investigated the role of phosphatidylcholine in the development of cardiovascular diseases and occurrence of adverse cardiac events. Researchers fed healthy subjects with two boiled eggs and deuterium labeled phosphatidylcholine. The concentrations of choline, betaine, and trimethylamine-N-oxide (TMAO) were measured in the blood and urine of the subjects before and after the administration of oral antibiotics to suppress the activity of intestinal microbes.

Researchers discovered that increased risk of adverse cardiovascular events (myocardial infarction, and stroke), morbidity, and mortality was associated with high plasma and urine levels of TMAO. However, the administration of antibiotics, which suppress the activities of microbes in the intestines, was observed to reduce the concentrations of TMAO in the blood and urine. The findings of this study show that high intestinal microbial metabolism of phosphatidylcholine to TMAO may increase the risk of occurrence of adverse cardiac events and development of cardiovascular disease.