Despite extensive studies on Weddell seals (Leptonychotes weddellii) in McMurdo Sound since the 1960s, uncertainty still remains regarding female foraging habits during the lactation period. Based on their large body mass at the start of lactation and large relative mass loss at the end, the current hypothesis is that Weddell seals fast or feed to a neglible extent during lactation. However, this hypothesis has not been fully tested to date, as evidence for foraging is indirect and is based primarily on dive behaviour. The work presented in this thesis describes the development of a new dietary method, the biomarker method, and its application for studying the foraging behaviour of female Weddell seals during lactation. Biomarkers were used to (1) monitor the onset of feeding in individual animals, and (2) determine what prey females were feeding on using characteristic/taxon-specific biomarker patterns. Proton nuclear magnetic resonance spectroscopy (1H NMR) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) assays were developed to detect and quantify dietary biomarkers in biological samples, mainly tissues, serum and plasma. Trimethylamine N-oxide, arsenobetaine, dimethylsulfoniopropionate, homarine and glycine betaine were first measured in thirty-three prey and potential prey species of Weddell seals collected from the Ross Sea and McMurdo Sound regions of Antarctica. These same compounds were then measured in the plasma of twelve female Weddell seals over the lactation period at the Hutton Cliffs seal colony, McMurdo Sound in 2006. Time-depth recorders monitored seal dive activity over the same period. The data obtained from both NMR and LC-MS/MS assays showed that biomarkers in Antarctic species varied both in content and concentration. The compound homarine, which occurs primarily in cephalopods, is suitable for distinguishing between major food groups of known prey of Weddell seals (i.e., fishes versus cephalopods). DMSP, a compound that occurs primarily in fish common in McMurdo Sound (e.g., Trematomus bernacchii and Pagothenia borchgrevinki) but not in significant amounts in Dissostichus mawsoni or Pleuragramma antarcticum, two main prey items for Weddell seals, may also be a suitable biomarker for distinguishing between major and minor prey types. The detection of plasma TMAO, AsB and homarine indicated that 75% of Weddell seals studied fed during lactation. The presence of these three compounds indicates the seals were preying upon a combination of fish and cephalopods. Two lactating females started foraging as early as 9 to 12 days postpartum and elevated biomarker levels were concurrent with increased dive activity. The onset of foraging and dive behaviour amongst individuals was highly variable; however, the results suggests that the number of females who feed during lactation may be more prevalent and initiated at an earlier stage than previously thought. This may have implications for future reproductive success given effects of climate change on sea ice abundance and resource availability. Overall, the work presented in this thesis provides new insights into the foraging behaviour of female Weddell seals during lactation and has added to the current knowledge of the biomarker distribution within the Antarctic ecosystem.

Cardiovascular disease (CVD) is a major cause of mortality and morbidity worldwide, often with heart failure as the terminal stage. Clinical studies have associated elevated levels of trimethylamine N-oxide (TMAO), a gut-derived metabolite, with adverse outcomes of CVD. As of today, TMAO's effects on cardiac structure and function are not well understood. In this study, both male and female TMAO-treated hearts showed functional deficits based on electrocardiography and echocardiography results. Immunohistochemistry results showed signs of hypertrophic cardiomyopathy in TMAO-treated male hearts while female TMAO-treated hearts showed signs of dilated cardiomyopathy. Neither TMAO group showed signs of fibrosis. Overproduction of reactive oxygen species was only observed in male TMAO-treated hearts. At the level of individual cardiomyocytes, significant delays in time to reach maximum contraction and dilation were only seen in TMAO-treated male hearts along with higher contractile force. Overall, TMAO-treated hearts show significant functional deficits with altered structure in a sex-specific way. Our study utilizes a variety of methods to comprehensively characterize features of TMAO-induced heart failure in both males and females which extends our current knowledge from human clinical associations. / Master of Science / Cardiovascular disease (CVD) is a major cause of mortality and morbidity worldwide, often with heart failure as the terminal stage. Clinical studies have associated elevated levels of trimethylamine N-oxide (TMAO), a compound derived from eggs, red meat and seafood, with adverse outcomes of CVD. As of today, TMAO's impact on the heart is not well understood. After supplementing mice with TMAO, we discovered deficiencies in heart function coupled with altered heart structure showing signs of hypertrophic cardiomyopathy in males and dilated cardiomyopathy in females. In-depth experiments suggest that TMAO-induced cell stress could be a potential underlying cause of previously mentioned changes but the specific mechanisms require further investigation. Overall, TMAO-treated hearts show significant functional deficits with altered structure in a sex-specific way. Our study utilizes a variety of methods to characterize features of TMAO-induced heart failure aiming to unravel relevant biological changes in both male and female mice which extends our knowledge from human clinical associations.

Cardiovascular diseases (CVDs) are the leading cause of death and disability worldwide. The aging population and the rapidly increasing prevalence of obesity and type 2 diabetes will contribute to a growing epidemic of CVDs globally. Despite the extensive investigations in etiology, the pathogenesis of CVDs still not fully understand, and the treatment and prevention for CVDs are still limited. Significant interest has been raised in gut microbiota-host interaction since increasing evidence revealed that gut microbiomes play an important role in human health and diseases, including CVDs. Among more than two thousand gut microbiota metabolites, a compound named trimethylamine N-oxide (TMAO) was revealed to be closely related to CVDs. However, the impact of TMAO on cardiovascular health is still full of controversy and the direct impact of TMAO on heart tissue and cardiomyocytes has not been fully understood yet. In the first chapter, we reviewed the literature on TMAO-related atherosclerosis and cardiomyopathy to give us a general aspect of current research progress in the role of TMAO on CVDs. In this context, we provide an overview of the potential mechanisms underlying TMAO-induced cardiovascular diseases at the cellular and molecular levels, with a focus on atherosclerosis and cardiomyopathy. We also address the direct effects of TMAO on cardiomyocytes (a new and under-researched area) and finally propose TMAO as a potential biomarker and/or therapeutic target for the diagnosis and treatment of patients with CVDs. In the second chapter, the direct impact of TMAO on cardiac function was tested in vivo using wild-type C57B6L mice model. Four experiment groups were enrolled in the feeding protocol, which included 3w (different time points), 6w, and 13w feeding time to reveal the impact of short and longer periods of TMAO consumption on cardiac function. The plasma TMAO was measured by liquid chromatography-tandem mass spectrometry (LC/MS/MS) method at the end of the feeding protocol. Echocardiography and electrocardiography (ECG) were performed to assess the overall heart function. The histopathology staining was used to evaluate the cardiac microstructure change. By the end of the feeding protocol, the plasma TMAO all increased significantly in the TMAO group compared to the control no matter the TMAO feeding period. Echocardiography showed that 6w and 13w TMAO intake could significantly decrease cardiac contractility evidenced by decreased eject fraction (EF) and fraction shortening (FS). The electrocardiography (ECG) showed decreased R wave aptitude in 6w and 13w TMAO feed group with sinus rhythm. However, 3w TMAO intake had no impact on both cardiac contractability and ECG. Moreover, chronic TMAO supplement (13w) showed increased left ventricle (LV) mass on echocardiography and increased LV thickness on the tissue section. Further histology analysis revealed cardiomyocyte hypertrophy in the 13w TMAO-treated male group. Notably, the female mice showed significantly higher TMAO levels both in the control and treated group compared to the male, however, no gender difference was observed as to the ECG and echocardiography. In addition, the plasma inflammation cytokines were also analyzed and the tumor necrosis factor-α (TNF- α), interleukin 10 (IL-10), Fibroblast growth factor 2 (FGF β) and leptin were all increased in the 13w TMAO treated group compared to the control. These results suggest that chronic TMAO exposure led to increased plasma TMAO levels, which contribute to system inflammation and cardiac dysfunction due to cardiac hypertrophy in mice models. Research in chapter 3 demonstrates the potential underlying mechanisms of TMAO-induced cardiac dysfunction using adult mouse cardiomyocytes. In this study, we examined the direct effect of TMAO on reactive oxidative species (ROS) generation and factors related to cardiomyocyte contractibility, including, microtubule, Connexin43 (Cx43) expression, and gap junction intracellular communication (GJIC), intracellular calcium dynamics and transversal-tubule (T-tubule) both in acute and chronic TMAO challenge. Moreover, we also tested whether TMAO can enter cardiomyocytes directly. The results suggested that TMAO could enter cardiomyocytes through organic cation transporters (OCTs) and promote increased ROS generation via augmentation of NADPH oxidase 4 (Nox4). Moreover, both acute and chronic TMAO exposure could induce microtubule densification, which plays a critical role in intracellular protein transportation and cardiomyocyte morphology maintenance. We also demonstrated chronic TMAO exposure could inhibit the Cx43 expression at both cellular and tissue level, and therefore impact the GJIC for the first time. Besides, we also revealed that TMAO could interrupt intracellular calcium handling both acutely and chronically, especially documented by decreased efficiency in intracellular calcium removal, related to decreased sarcoplasmic reticulum Ca2+-ATPase (Serca2) expression. However, TMAO showed no impact on cardiomyocyte T-tubule network organization. Taken together, we demonstrated a direct destructive role of TMAO on cardiomyocytes' functional properties and provided a novel potential mechanism for TMAO-induced cardiac dysfunction. Overall, the research in this dissertation demonstrated the direct impact of TMAO on cardiomyocytes and cardiac function both in vivo and in vitro and evaluated the effect of TMAO both acutely and chronically. The TMAO can enter cardiomyocytes and induce Nox4-mediated oxidative stress, which could connect to multiple intracellular pathways, including microtubule densification, decreased Cx43 expression, and GJIC, as well as calcium handling dysfunction. Meanwhile, all these changes were closely related to the cardiomyocyte swelling observed in mice cardiac tissue after chronic TMAO consumption, which could ultimately contribute to cardiac contractile dysfunction and electrophysiology change in mice models. / Doctor of Philosophy / Cardiovascular diseases (CVDs) are a group of diseases related to our heart and blood vessels, such as heart attack and stroke. It is the leading cause of death and disability around the world, more common than diabetes and cancer. According to the reports of the American Heart Association, CVDs cost America 555 billion US dollars in 2016 while by 2035, the cost will reach 1.1 trillion. The individual, population, and economic impact of CVDs are tremendous, making CVD one of the largest public health problems at present. Despite the extensive investigations into the cause of CVDs, the exact underlying reason still not fully understand. The microbiome inside our body has raised much attention recently due to its close relationship with human health, including CVDs. The microbiome from the gut can affect our heart health both by affecting the immune system and its metabolites after we eat daily foods. Among thousands of metabolites, one named trimethylamine N-oxide (TMAO) has been shown to be related to increased CVDs risks. After we eat choline-rich food such as red meat and eggs, the gut microbiome can use these nutrients and produce TMA as metabolite waste, the TMA then goes into the liver and convert to TMAO via liver enzymes. However, the impact of TMAO on cardiovascular health is not fully understood yet. Our study uses the mice model to test whether TMAO has a direct impact on heat cells and heart function. We fed the mice with water containing 0.12% TMAO for different times including 3w, 6w, and 13w, and then check the mice's heart function through heart ultrasound and ECG. The results showed that TMAO could significantly harm heart function after long-term exposure in mice (13w). Further histology analysis of heart tissue showed increased heart cell size, which may contribute to decreased heart function. Certain blood inflammation cytokines related to CVDs also increased. The experiments using isolated mice heart cells showed that the ROS, which could harm the heart cells and related to lots of other damage processes in human health, were increased after exposure to the TMAO. Several other factors, including cell skeleton, cell channels responsible for cell-to-cell communication, and cell calcium balance were all damaged by TMAO, which could finally induce heart damage and heart diseases.

A obesidade, doença multifatorial, ocasiona inúmeros distúrbios no metabolismo lipídico e energético, provocando disfunção na bioenergética mitocondrial. A partir deste fato, o presente estudo teve como hipóteses que: o desequilíbrio na bioenergética mitocondrial e as alterações metabólicas causadas pela obesidade são terapeuticamente modificados com o treinamento físico. Dessa maneira, o objetivo do estudo foi avaliar a capacidade oxidativa e conteúdo mitocondrial em tecido adiposo branco, marcadores de doenças cardiosculares (esfingolipídios e N-óxido de trimetilamina, TMAO) e as alterações na composição corporal, desempenho físico e taxa metabólica de repouso (TMR) de mulheres com obesidade submetidas a treinamento físico combinado. A casuística do presente trabalho foi composta de 14 mulheres adultas jovens com diagnótico clínico de obesidade (IMC 33±3 kg/m² e idade 35±6 anos). Foram submetidas a um programa de treinamento físico combinado (exercícios aeróbios e força alternadamente, 55 min à 75-90% da frequência cardíaca máxima, 3 vezes por semana, durante 8 semanas). Todas as participantes foram avaliadas antes e após a intervenção com o treinamento, quanto a: composição corporal, TMR, oxidação de substratos (carboidrato e lipídios) e coeficiente respiratório (QR), desempenho físico, capacidade oxidativa (respiração acoplada: VADP/VOLIGO, e respiração desacoplada: VOLIGO/VCCCP) e conteúdo mitocondrial (enzima citrato sintase, CS) em tecido adiposo branco, nível de esfingolípidios, TMAO e precursores plasmáticos. Os dados foram analisados pelo test t pareado ou Wilcoxon (as pacientes foram consideradas controle de si próprio), após determinação da normalidade da amostra, considerado nível de significância p<= 0,05. Após a intervenção (treinamento físico combinado), houve o aumento da TMR, oxidação de lipídios e desempenho físico, com redução da oxidação de carboidratos e QR, mas não houve perda de peso e alteração da composição corporal. Após o treinamento combinado houve, o aumento da atividade da enzima CS (marcador de conteúdo mitocondrial) e redução à respiração desacoplada (VOLIGO/VCCCP). No plasma, o treinamento físico foi capaz de reduzir os níveis de esfingolipídios e TMAO (fatores de risco cardiovasculares). Também foram encontradas correlações positivas entre TMR, oxidação de lipídios e desempenho físico com CS e negativamente correlacionado com respiração desacoplada. Concluindo, o treinamento físico em mulheres com obesidade aumentou o metabolismo energético, com aumento da TMR, conteúdo e grau de acoplamento mitocondrial, aumentou o desempenho físico e reduziu fatores de risco cardiovasculares (TMAO), independente da perda de peso. / The obesity, a multifactorial disease, causes various metabolic disorders in lipid and energy metabolism, may induce mitochondrial bioenergetic dysfunction. From this, the present study hypothesized that: mitochondrial bioenergetics dysfunction and metabolic problems caused by obesity are be therapeutically modified with physical training. Thus, the objective of study was to evaluated: the oxidative capacity and mitochondrial content in white adipose tissue, markers of cardiovascular diseases (sphingolipids and trimethylamine N-oxide, TMAO) and changes of body composition, physical performance and resting metabolic rate (TMR) of obese women submitted to combined physical training. The present study was composed of 14 young women with obesity (BMI 33 ± 3 kg/m² and age 35 ± 6 years old). They underwent a combined physical training program (aerobic exercises and strength alternately, 55 min at 75-90% of maximal heart rate, 3 times a week, for 8 weeks). All participants were evaluated before and after the intervention: body composition, TMR, substrates oxidation (carbohydrate and lipids) and respiratory coefficient (RQ), physical performance, oxidative capacity (by mitochondrial respiration - Couple: VADP/VOLIGO; Uncoupling: VOLIGO/VCCCP) and Citrate Sinthase activity in white adipose tissue, level of sphingolipids, TMAO and precursors from plasma. Data analysis were made by paired t test or Wilcoxon, after normality determination of the sample, with level of significance p <0.05. After intervention with combined physical training, there was an increase in TMR, lipid oxidation and physical performance, reduced carbohydrate oxidation and RQ, but did not cause weight loss and changes of body composition. In adipose tissue, physical activity increased CS activity (mitochondrial content marker) and reduced uncoupling respiration (VOLIGO/VCCCP). In plasma, physical training was able to reduce levels of sphingolipids and TMAO (cardiovascular risk factors). In addition, positive correlations were found between, TMR, lipid oxidation and physical performance with CS and negatively correlation with uncoupling respiration. Therefore, physical training in obese women improve energy metabolism, with increased TMR, content and degree of mitochondrial coupling, increased physical performance and reduced cardiovascular risk factors, regardless of weight loss.

Trimethylamine-n-oxide (TMAO) is a metabolite found in plasma/serum in humans. Elevated levels of TMAO have been associated with several types of heart disease. It’s therefore of interest to make a simple analytical method to analyse TMAO and other metabolites that are degraded to TMAO, including betaine. In this study, the goal was to develop a method for the sample preparation and analysis of these compounds in human plasma. Sample preparation was performed with an Ostro 96-well method for sample clean-up. The analysis was performed by ultraperformance liquid chromatography – hydrophilic interaction liquid chromatography – tandem masspectrometry (UPLC-HILIC-MS/MS) in multiple reaction monitoring (MRM)-mode using electrospray ionization in positive mode (ESI+)-mode as the ion source. The analytes eluted under five minutes and were all baseline separated in the chromatogram. TMAO and betaine were quantified in quality control (QC) plasma samples using external calibration. Concentration of TMAO ranged from 132 ng/mL – 253 ng/mL and 1025-2084 ng/mL for betaine. Due to the lack of isotopically labelled standards for TMAO and betaine, valine-d8 was tested as an internal standard for the extraction; however, it was not a suitable option due to the low recovery obtained (5-34%) and the low response in ESI+. The recovery needs to be investigated further using isotopically labelled TMAO or betaine. Overall, the developed UPLC-HILIC-MS/MS method was found to be suitable for analysis of TMAO and betaine in human plasma. Further development and validation is required before application to samples from clinical studies.

The prevalence of cardiovascular disease is a major public health concern worldwide. It has been theorized that diets rich in fruits and vegetables may be protective against the development of cardiovascular disease mainly through their high content of flavonoids. Flavonoids were thought to influence traditional risk factors of cardiovascular disease such as blood pressure, lipid profile, and systemic inflammation. Recent clinical studies have shown that this may not be the case. The production of trimethylamine oxide (TMAO) by the gut microbiota from dietary sources of choline has been associated with an increased risk of cardiovascular events. The objectives of this study were to determine the effects of a high flavonoid diet on gut microbiota composition and plasma trimethylamine oxide concentrations. Potential benefits of this research include the determination of a potential correlation between diet and markers of traditional and non-traditional risk factors for cardiovascular disease. Also, the effects that a high flavonoid diet has on the composition of the gut microbiota and plasma trimethylamine oxide concentrations may provide insight into possible dietary interventions to prevent cardiovascular disease.

OBJECTIVE: Chapter 1: Investigate the impact that trimethylamine N-oxide (TMAO), dietary contribution of short chain fatty acids (SCFAs), and role of bile acids has on cardiovascular health and disease. Chapter 2: Evaluate the association between intakes of dietary protein from both animal and plant sources on lipid profile changes. METHODS: Chapter 1: Literature review using PubMed and EMBASE to search for published studies for dietary intake or supplementation impact on TMAO or its precursors and their role in the development or prevention of cardiovascular diseases. Chapter 2: Framingham Offspring Study, prospective cohort study using statistical methods to investigate the changes in lipid profiles with dietary animal and plant protein. PUBLISHED STUDIES/RESULTS: Chapter 1: The increased risk of cardiovascular diseases (CVD) correlates with increasing levels of circulating levels of TMAO. The risk of CVD in animal and human studies have shown to be distinct in groups with and without CVD, leading to either beneficial or adverse effects from the consumption of dietary phosphatidylcholine, choline, betaine, carnitine, or intact TMAO. A Western dietary approach has been linked with the development of dyslipidemia whereas, adherence to a Mediterranean diet reduces the risk of major CVD events. The dietary precursors involved in TMA production by the gut microbiota then respectively to TMAO through hepatic enzyme FMO3 provide both beneficial and detrimental effects. Mechanisms of action for TMAO on CVD risk involves changes associated with cholesterol and sterol metabolism leading to foam cell formation, and enhancement of scavenger receptors, CD36 and scavenger receptor-A, on macrophages affects the rate of cholesterol influx and efflux. Choline derived in a dose-dependent manner from eggs improves cardiometabolic biomarkers with no changes in fasting TMAO. Further, choline from eggs also increases the lipoprotein particle size for both HDL-cholesterol and LDL-cholesterol increasing the rate of reverse cholesterol transport (RCT). Betaine concentrations in humans are associated with health outcomes based on an individual’s overall systemic health at baseline. Supplementation with L-carnitine produced favorable effects in lean subjects compared to obese subjects, improved cardiometabolic status in patients with myocardial infarction, and improved lipid profiles among individuals with prevalent coronary heart disease (CAD). Fish consumption increases concentrations of TMAO due to its high levels of intact TMAO though, protective effects for CVD are obtained from fatty fish providing omega-3-fatty acids impacting positive changes in the lipid profiles. Antibiotic therapy suppresses the gut microbiota and eliminates the production of TMA from the dietary precursors that are required. Chapter 2: Men and women both showed a decreasing trend for LDL-cholesterol as the tertiles increased for animal protein intake. Plant protein intake showed a similar decreasing trend for LDL-cholesterol with increasing protein tertiles; however, men had inconsistency among the trend whereas women had a consistent decreasing trend. HDL-cholesterol content increases in males and females with both increasing tertiles for animal and plant protein, though plant protein presented much stronger effects when compared to animal protein. Log-transformed triglycerides were inversely associated with increasing animal protein intake, men revealing greater effects than females. Plant protein intake showed a stronger effect than animal protein intake in an increasing trend in the log of triglycerides over the 6 exams. Overall, total cholesterol content varied at each examination period, animal protein intake tertiles displayed decreased level of total cholesterol, there was a greater effect in men than women. Higher intake of plant protein had a similar trend to animal protein intake showing a decrease in the total cholesterol concentration. Women had a much greater effect in reducing total cholesterol with plant protein when compared to men. CONCLUSION: Chapter 1: Multiple human and animal trials addressed in the association between diet, dietary precursors, gut microbiota composition, and their derived metabolite TMAO on the presence or absence of CVD display contradictory results and identifies areas needing further study. Chapter 2: Regardless of the source of protein, the lipid profiles improved with the intake of either animal or plant protein as the protein intake was increased over the tertiles in each exam. The overall trend with increasing animal or plant protein intake led to decrease in LDL-cholesterol, log transformed triglycerides, and total cholesterol whereas, the HDL-cholesterol concentrations were increased. Men favored animal protein intake to show greater reductions in LDL-cholesterol and total cholesterol, whereas women favored plant protein. The increase in HDL-cholesterol concentration was stronger with the intake of plant protein in men and women. The changes in log transformed triglycerides were similar in men and women.

No description available.

Type II Diabetes Mellitus (T2D) and cardiovascular diseases (CVD) are non-communicable chronic diseases that involves impairments in glucose metabolism and vascular function. Multiple factors may increase the risk for T2D, including but not limited to genetics, obesity and lifestyle, such as physical inactivity and diet. The gut microbiota, the human's largest population of microorganisms, plays an essential role in health and disease. The physiology and function of the gastrointestinal tract can be influenced by the diet. Phosphatidylcholine (PC), a source of choline in the diet, is rich in Western-type diets. Gut microbiota metabolize choline to trimethylamine (TMA) which circulates and is oxidized in the liver to form trimethylamine N-oxide (TMAO). As a result, ingestion of PC or choline could increase levels of TMAO. Preclinical studies indicate a role of TMAO in the development of atherosclerosis. Likewise, multiple observations support a potential role of TMAO in the development of insulin resistance and T2D. Much of the research has been conducted on rodent models, while others are observational human studies. Whether acute and short-term increases in TMAO contribute to impairments in insulin sensitivity in humans remains unknown. To address this, we performed two studies utilizing a double-blind, placebo controlled, crossover design. Eligible participants consumed a 1000mg/day dose of choline bitartrate and placebo (maltodextrin) the night before each testing session (for the acute choline study) or for 4 weeks (for the short-term choline ingestion study). Oral glucose tolerance test, continuous glucose monitoring, flow-mediated dilation, and applanation tonometry was performed the day after the acute choline load and before and after the short-term choline ingestion period. We hypothesized that gut microbiota-generated increase in TMAO will impair insulin sensitivity, glucose tolerance, endothelial function and arterial stiffness in healthy sedentary humans. Following acute choline ingestion, significant increases in plasma TMAO (p = 0.013) and choline (p = 0.003) were evident. There was no statistically significant difference in insulin sensitivity, glucose tolerance or in any of the endothelial function and arterial stiffness measurements. Four weeks of 1000mg choline ingestion per day, significantly increased plasma (p = 0.042) and urine (p = 0.008) TMAO concentrations compared to the placebo. However, no significant differences were observed for any other measurements of insulin sensitivity, glucose tolerance, glycemic variability, endothelial function, and arterial stiffness. More research is needed to elucidate the mechanisms behind the mechanistic observations between elevated TMAO concentrations and T2D and CVD. / Doctor of Philosophy / Type 2 diabetes mellitus (T2D) and cardiovascular diseases (CVD) increase the risk of all-cause mortality. Choline is a nutrient that can be found in foods such as red meat, dairy, fish, and eggs. Choline is metabolized from bacteria in our gut and a metabolite called trimethylamine (TMA) is formed. TMA is then oxidized in the liver and trimethylamine-N-oxide (TMAO) is produced. A Western-type diet is rich in red meat, dairy, fish, and eggs and has been shown to increase production of the compound TMAO. Preclinical studies have suggested a causal role of TMAO in atherosclerosis and T2D and elevated plasma TMAO concentrations have been associated with an increased risk for CVD and T2D in observational studies. However, the causal nature of this relationship in humans is unknown. The studies described herein aimed to investigate the effects of increases in TMAO on insulin sensitivity and vascular function in healthy adults. The first study tested the effect of increasing TMAO on insulin sensitivity, glucose tolerance, and vascular function following an acute choline load (1000mg) and placebo (carbohydrate) the night before each testing session. In the second study, we examined the effect of increasing TMAO on insulin sensitivity, glucose tolerance, and vascular function in healthy adults, following a short-term choline load (1000mg/day) and placebo (carbohydrate) for 4 weeks. Acute and short-term choline ingestion significantly increased plasma TMAO concentrations. No significant differences were observed following acute or short-term choline ingestion for any measurement of insulin sensitivity, glucose tolerance 24-hout glycemic variability, vascular function., and arterial stiffness.

Trimethylamine-N-oxide (TMAO) is an important biomarker of atherosclerosis. TMAO is the product of a hepatic conversion of trimethylamine (TMA). Releasing of TMA moieties is dependent on the adaptation of the gut microbiota to dietary TMA containing substrates such as phosphatidylcholine (PC), choline, and L-carnitine. A high-fat diet is an environmental risk factor that may increase TMAO production. However, it isn’t clear if the high dietary intake of TMA is sufficient to promote increased plasma TMAO or if a high-fat intake is also required. We hypothesized that TMAO would be increased after consuming a high-fat diet and a high PC diet independently, with greater increases when consumed together. Four groups of twelve mice each were maintained on different treatments that were either low or high-fat with or without PC over two weeks. Then, a meal containing 9.99 g of corn oil and 0.75 g soybean L-α-Lecithin per 1 kg body weight was provided to all mice to indirectly observe the adaptation of the microbiota to the altered diet. The results of circulating TMAO levels showed that fat appeared to suppress TMAO production, which is against previous evidence. The microbial adaptation to the different treatments wasn’t observed in the measurement of fecal TMA levels. As a result, our hypothesis was rejected. Future work addressing the impact of gene expressions of enzymes on the gut and the liver is needed. The use of another high TMA containing substrates such as choline and rats is recommended. / Master of Science in Life Sciences / Cardiovascular disease (CVD) is heart and blood vessel diseases - many of which are caused by atherosclerosis, a condition wherein fatty materials accumulate in the artery wall, reducing blood flow. The compound trimethylamine-N-oxide (TMAO) was found to be an important biomarker of atherosclerosis. TMAO levels increase in the body when gut microbiota releases trimethylamine (TMA) moieties from dietary phosphatidylcholine (PC), choline, and L-carnitine such as eggs and meat. A high-fat intake was believed to have an impact on increased levels of TMAO. However, it wasn’t clear if the dietary intake of high TMA containing substrates such as PC, is sufficient to promote TMAO formation or if a high-fat content is also required. We hypothesized that TMAO would be increased after consuming a high-fat diet and a high PC diet independently, with greater increases when consumed together. The results would suggest new dietary strategies to avoid CVD. Four groups of twelve mice each were maintained on different treatments that were either low or high-fat with or without PC over two weeks. Then, a meal containing corn oil and PC was provided to all mice to observe the adaptation of the microbiota to the altered diet. The results showed that fat reduces circulating TMAO production, which is against previous evidence. Fecal TMA levels showed that microbiota activities weren’t observed in the colon. As a results, no significant levels of TMA and its precursors were observed in feces.