Effects of prebiotics and phytochemicals on serum trimethylamine N-oxide reduction and gut microbiota: a systematic review and meta-analysis

作者：Zhengwei Wan, Linjie Zheng, Yifei Huang, Jingwen Xie, Jianli Li, Yi-Ran Chen · 发表于：Journal of Translational Medicine · 年份：2025 · DOI：10.1186/s12967-025-06806-7 · 被引用次数：11 · 研究领域：Gut microbiota and health、Diet and metabolism studies、Gastrointestinal motility and disorders

Serum trimethylamine N-oxide (TMAO) level has been considered as a potential biomarker linking gut microbiota to multiple diseases. Prebiotics and phytochemicals have emerged as promising non-pharmacological agents for regulating TMAO levels and promoting overall health, attracting significant interest in recent research. However, existing evidence on their efficacy remains inconsistent. To address this, we conducted a systematic analysis of 41 studies (from PubMed, Web of Science, Embase, and Cochrane Library up to May 19, 2025) evaluating the effects of prebiotics and phytochemicals on gut microbiota and TMAO level. Included studies had interventional and longitudinal designs, analyzed gut microbiota, reported diversity or abundance measures, and measured changes in trimethylamine (TMA) or TMAO levels. Hedge’s g standardized mean difference (SMD) and heterogeneity (I 2 ) were calculated to quantify the effects of prebiotics and phytochemicals on TMA, TMAO, and gut microbiota alpha-diversity. Microbial changes and beta-diversity were synthesized qualitatively. Our meta-analysis revealed that prebiotic and phytochemical interventions significantly reduced serum TMAO levels (SMD = − 2.31, 95% CI, − 2.75 to − 1.87; I 2 = 76.00%, p < 0.01) in animals, with clinical trials showing similar results (SMD = − 0.82, 95% CI, − 1.55 to − 0.08, I 2 = 91.00%, p < 0.01). In animals, TMA levels were also significantly reduced (SMD = − 1.53, 95% CI, − 2.04 to − 1.02; I 2 = 71.00%, p < 0.01)....