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Letter to the editor about published meta-analysis of TMAO and stroke

European Journal of Clinical Nutrition volume 77, page 761 (2023)Cite this article

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The Original Article was published on 25 April 2022

We would like to comment on the article by Hongmei Zhang and Guifen Yao, published in the European Journal of Clinical Nutrition on April 25, 2022 [1]. We have found serious issues with this article that warrant close attention.

  1. 1.

    The title of the article “Significant correlation between the gut microbiota-derived metabolite trimethylamine-N-oxide and the risk of stroke: evidence based on 23 observational studies” is highly misleading. The article did not include 23 observational studies of stroke. Only five studies were meta-analyzed to obtain a pooled OR of stroke of 1.83 (95% CI: 3.16–9.26), as shown in Figure 4 of the article.

  2. 2.

    The abstract states, “The present meta-analysis included 30,808 participants and revealed that being in the higher TMAO category increased the odds of stroke by 68% (OR 1.83; 95% CI 1.02–3.29; P = 0.04)”. However, the combined sample size of the five studies listed in Figure 4 is only 3887 (980 + 227 + 1244 + 220 + 1216, numbers taken from the article Table 1).

The title of the article “Significant correlation between the gut microbiota-derived metabolite trimethylamine-N-oxide and the risk of stroke: evidence based on 23 observational studies” is highly misleading. The article did not include 23 observational studies of stroke. Only five studies were meta-analyzed to obtain a pooled OR of stroke of 1.83 (95% CI: 3.16–9.26), as shown in Figure 4 of the article.

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References

  1. Zhang H, Yao G. Significant correlation between the gut microbiota-derived metabolite trimethylamine-N-oxide and the risk of stroke: evidence based on 23 observational studies. Eur J Clin Nutr. 2022. https://doi.org/10.1038/s41430-022-01104-7.

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Authors and Affiliations

  1. Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA

    Rozenn N. Lemaitre & Paul N. Jensen

  2. Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA, USA

    Dariush Mozaffarian

Authors
  1. Rozenn N. Lemaitre
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  2. Paul N. Jensen
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  3. Dariush Mozaffarian
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Contributions

Each author contributed to drafting the Letter to the Editor and approved the submission.

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Correspondence to Rozenn N. Lemaitre.

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Lemaitre, R.N., Jensen, P.N. & Mozaffarian, D. Letter to the editor about published meta-analysis of TMAO and stroke. Eur J Clin Nutr 77, 761 (2023). https://doi.org/10.1038/s41430-022-01255-7

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