Kidney Week

Abstract: SA-PO551

Trimethylamine-N-Oxide and Renal Complications, Cardiovascular Disease, and Mortality in Individuals with Type 2 Diabetes and Microalbuminuria

Session Information

• Diabetic Kidney Disease: Pathology, Epidemiology
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Winther, Signe Abitz, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Signe Abitz Winther,

• Øllgaard, Jens Christian, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Jens Christian Øllgaard,

• Hansen, Tine, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Tine Hansen,

• Von Scholten, Bernt Johan, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Bernt Johan Von Scholten,

• Gaede, Peter, Slagelse Hospital, Denmark, Denmark

Peter Gaede,

• Parving, Hans-Henrik, Rigshospitalet, Copenhagen, Denmark

Hans-Henrik Parving,

• Pedersen, Oluf, Novo Nordisk Foundation Center for Basic Metabolic Research, København Ø, Denmark

Oluf Pedersen,

• Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark

Peter Rossing,

Background

Trimethylamine-N-Oxide (TMAO) is suggested as an independent gut microbiota derived risk marker for several diseases. We investigated associations between plasma TMAO concentrations and all-cause mortality, cardiovascular disease (CVD) and deterioration in renal function in individuals with type 2 diabetes and microalbuminuria.

Methods

Plasma TMAO was measured at baseline in 311 individuals with type 2 diabetes and microalbuminuria. All-cause mortality and CVD (fatal and non-fatal) were tracked from national registries. Yearly p-creatinine was measured after baseline in 166 of the participants, the renal endpoint was defined as eGFR-decline of >30%. Associations between TMAO and events were analyzed using Cox regression models. Adjusted models included age, sex, HbA1c, systolic blood pressure, total cholesterol, urine albumin excretion rate and eGFR.

Results

Baseline mean (SD) age was 57.2 (8.2) years, 75% were male and median [IQR] of TMAO was 5.87 [3.79-9.04] µM. TMAO was negatively associated with eGFR at baseline (R²=0.108, p<0.0001). Follow-up was up to 21.8 years for all-cause mortality and CVD events (median 6.8 and 6.5 years) and for renal events up to 5.8 years (median 4.6 years). We recorded 106 cases of mortality, 116 CVD events and 41 renal events. Higher plasma TMAO concentrations were associated with renal events in unadjusted analyses (p=0.03), but not after adjustment p=0.17. TMAO was not associated with mortality (unadjusted p=0.53; adjusted p=0.87) or CVD events (unadjusted p=0.14; adjusted p=0.24).

Conclusion

In individuals with type 2 diabetes and microalbuminuria, plasma TMAO was negatively correlated with eGFR at baseline. Moreover, higher plasma TMAO was in unadjusted analysis associated with renal events, but not after adjustment. Plasma TMAO was not associated with mortality and CVD events.

Funding

• Private Foundation Support