TY - JOUR
T1 - Folic acid supplementation and serum trimethylamine oxide (TMAO) lowering
T2 - new insight from the post hoc analysis of Precision Folic Acid Trial to lower homocysteine (PFAT-Hcy)
AU - the Precision Folic Acid Trial to lower homocysteine (PFAT-Hcy) Trial Investigators
AU - Tan, Ziheng
AU - Ding, Congcong
AU - Li, Junpei
AU - Cao, Tianyu
AU - Liu, Lishun
AU - Song, Yun
AU - Chen, Ping
AU - Zhang, Yan
AU - Li, Jianping
AU - Huo, Yong
AU - Wang, Hong
AU - Bao, Huihui
AU - Huang, Xiao
AU - Cheng, Xiaoshu
AU - Cheng, Xiaoshu
AU - Huo, Yong
AU - Wang, Xiaobin
AU - Li, Jianping
AU - Zhang, Yan
AU - Sun, Ningling
AU - Lu, Xinzheng
AU - Wu, Yanqing
AU - Tang, Genfu
AU - Li, Ping
AU - Wang, Binyan
AU - Qin, Xianhui
AU - Bao, Huihui
AU - Huang, Xiao
AU - Liu, Lishun
AU - Li, Junpei
AU - Ding, Congcong
AU - Xiong, Yurong
AU - Tan, Ziheng
AU - Zhou, Ziyi
AU - Wang, Zhuo
AU - Wei, Yaping
AU - Jiang, Chongfei
AU - Xie, Liling
AU - Hu, Lihua
AU - Song, Yun
AU - Chen, Ping
AU - Zhou, Wei
AU - Wang, Tao
AU - Zhu, Lingjuan
N1 - Publisher Copyright:
Copyright © 2024 The Author(s), Published by Wolters Kluwer Health, Inc.
PY - 2024/6/12
Y1 - 2024/6/12
N2 - Background: The impact of folic acid supplementation on trimethylamine oxide (TMAO) levels in hypertensive patients have not been well-studied. This study sought to investigate the association between folic acid supplementation in a range of doses and corresponding change in serum TMAO levels among Chinese hypertensive patients. Methods: This is a post hoc analysis of 1562 hypertensive patients from Precision Folic Acid Trial to lower homocysteine (PFAT-Hcy) who were randomly assigned to one of eight folic acid daily treatment groups ranging from 0 to 2.4 mg (0, 0.4, 0.6, 0.8, 1.2, 1.6, 2.0, 2.4 mg). The duration of the treatment was 8 weeks. The endpoint of this study was the reduction in TMAO levels by the end of 8-week treatment compared to the baseline level. Results: In the overall sample, as the dosage of folic acid supplementation escalated from 0 to 2.4 mg, there was no statistically significant association between folic acid supplementation and TMAO changes. However, subgroup analysis revealed that the association between folic acid supplementation and TMAO lowering differed by the baseline TMAO levels. When baseline TMAO was in the lowest tertile (<1.4 μmol/L) or the middle tertile (1.4–2.5 μmol/L), there was no association between folic acid supplementation and TMAO changes. However, among those with baseline TAMO in the highest tertile (>2.5 μmol/L), there was a significant inverse association between folic acid supplementation dosage and TMAO changes, the adjusted β (95% confidence interval [CI]) among those with the highest TMAO tertile was −0.58 (−1.10, −0.06); (P for interaction, 0.009). In this subgroup, we further observed that those with baseline elevated total homocysteine (tHcy) levels benefited even more from folic acid supplementation (P for interaction: 0.047). Conclusions: In this sample of Chinese adults with hypertension, folic acid supplementation can significantly lower serum TMAO levels in the subgroup with elevated serum TMAO levels (>2.5 μmol/L), and within this subgroup, those with concomitantly elevated tHcy benefited even more.
AB - Background: The impact of folic acid supplementation on trimethylamine oxide (TMAO) levels in hypertensive patients have not been well-studied. This study sought to investigate the association between folic acid supplementation in a range of doses and corresponding change in serum TMAO levels among Chinese hypertensive patients. Methods: This is a post hoc analysis of 1562 hypertensive patients from Precision Folic Acid Trial to lower homocysteine (PFAT-Hcy) who were randomly assigned to one of eight folic acid daily treatment groups ranging from 0 to 2.4 mg (0, 0.4, 0.6, 0.8, 1.2, 1.6, 2.0, 2.4 mg). The duration of the treatment was 8 weeks. The endpoint of this study was the reduction in TMAO levels by the end of 8-week treatment compared to the baseline level. Results: In the overall sample, as the dosage of folic acid supplementation escalated from 0 to 2.4 mg, there was no statistically significant association between folic acid supplementation and TMAO changes. However, subgroup analysis revealed that the association between folic acid supplementation and TMAO lowering differed by the baseline TMAO levels. When baseline TMAO was in the lowest tertile (<1.4 μmol/L) or the middle tertile (1.4–2.5 μmol/L), there was no association between folic acid supplementation and TMAO changes. However, among those with baseline TAMO in the highest tertile (>2.5 μmol/L), there was a significant inverse association between folic acid supplementation dosage and TMAO changes, the adjusted β (95% confidence interval [CI]) among those with the highest TMAO tertile was −0.58 (−1.10, −0.06); (P for interaction, 0.009). In this subgroup, we further observed that those with baseline elevated total homocysteine (tHcy) levels benefited even more from folic acid supplementation (P for interaction: 0.047). Conclusions: In this sample of Chinese adults with hypertension, folic acid supplementation can significantly lower serum TMAO levels in the subgroup with elevated serum TMAO levels (>2.5 μmol/L), and within this subgroup, those with concomitantly elevated tHcy benefited even more.
KW - Folic acid
KW - Homocysteine
KW - MTHFR C677T
KW - Supplementation
KW - TMAO
UR - http://www.scopus.com/inward/record.url?scp=85204071770&partnerID=8YFLogxK
U2 - 10.1097/PN9.0000000000000075
DO - 10.1097/PN9.0000000000000075
M3 - Article
AN - SCOPUS:85204071770
SN - 2563-9021
VL - 3
JO - Precision Nutrition
JF - Precision Nutrition
IS - 2
M1 - e00075
ER -