{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:16:21Z","timestamp":1792181781720,"version":"4.4.0"},"reference-count":72,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Reviews"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Recent studies have discovered higher levels of circulating trimethylamine N\u2010oxide, a metabolite produced by gastrointestinal microbiota, among patients diagnosed with diabetes. This study presents an updated systematic review and meta\u2010analysis examining the association between trimethylamine N\u2010oxide levels and the risk of developing diabetes. PubMed and Scopus databases were searched for the studies published up to April 2024. Observational (cross\u2010sectional, case\u2013control, and cohort) studies examining the relationship between TMAO levels and diabetes were included in our systematic review and meta\u2010analysis, excluding non\u2010original research, non\u2010human studies, and non\u2010English publications. Out of 1538 publications, 32 studies focusing on type 2 and gestational diabetes were included. We conducted two distinct meta\u2010analyses investigating the association between TMAO levels and type 2 diabetes. First, we found significantly elevated TMAO levels in diabetic patients compared to non\u2010diabetics (standardized mean difference [SMD]: 1.21, 95% confidence interval [CI]: 0.13\u20132.28). Second, we observed that elevated TMAO levels were associated with 49% increased odds of diabetes (odds ratio [OR]: 1.49, 95% CI: 1.06\u20132.10). However, the pooled hazard ratio (HR) analysis did not reveal a statistically significant association (HR: 1.00, 95% CI: 0.62, 1.61). Moreover, the included studies showed a higher type 2 diabetes prevalence in the elevated TMAO group. Regarding gestational diabetes, we also detected a positive correlation with TMAO levels. Our study indicates that individuals with type 2 diabetes have notably higher TMAO levels compared to non\u2010diabetics. Furthermore, our systematic review suggests an elevated risk of developing both type 2 diabetes and gestational diabetes in individuals with higher TMAO levels.<\/jats:p>","DOI":"10.1111\/obr.13963","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T01:53:29Z","timestamp":1749606809000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Gut Microbiota\u2010Derived Trimethylamine N\u2010Oxide and the Risk of Diabetes: An Updated Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"26","author":[{"given":"Sammy","family":"Mohammadi","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute Tehran University of Medical Sciences  Tehran 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