In this study, Huang et al. reveal a novel association between serum trimethylamine oxide (TMAO) and diabetic kidney disease (DKD), indicating its potential as an independent risk factor for DKD. Significantly higher levels of TMAO were observed in patients with DKD compared with the control group and subjects with non-diabetic kidney disease. Previous research has linked gut microbiota-dependent TMAO to the development of type 2 diabetes mellitus (T2DM), with increased TMAO levels associated with insulin resistance and impaired glucose tolerance. However, this study did not find a statistically significant difference in serum TMAO levels between the group with diabetes and the control group, possibly due to the small sample size.

The study identified positive correlations between serum TMAO levels and blood urea nitrogen and serum creatinine levels, and a negative correlation with estimated glomerular filtration rate, consistent with previous findings in patients with chronic renal failure. Multifactorial logistic regression analysis confirmed that increased serum TMAO levels independently contribute to the development of DKD. TMAO clearance by the kidneys may be disrupted in chronic kidney disease, potentially due to changes in gut microbial homeostasis and increased trimethylamine-producing bacteria.

In conclusion, this study establishes a link between elevated serum TMAO levels and the risk of DKD in patients with T2DM, highlighting TMAO as an independent risk factor for DKD development.

Read the full article in Endocrine Connections 12 e220542