{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T10:21:32Z","timestamp":1775816492425,"version":"3.50.1"},"reference-count":26,"publisher":"Mattioli1885","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Microbiota refers to the microorganisms inhabiting specific environments, while the microbiome encompasses these organisms, their metabolites, and environmental factors. Variations in microbiota composition across body regions influence physiological processes, including metabolism, immunity, and skin health. Trimethylamine N-oxide (TMAO), a metabolite linked to gut dysbiosis, inflammation, and systemic diseases, has not been previously investigated in acne patients. Objective: We aimed to investigate the potential relationship between gut dysbiosis and acne vulgaris by assessing serum TMAO levels in acne patients compared to healthy controls. Methods: This case-control, cross-sectional study involved 70 acne patients and 70 age- and sex-matched healthy controls. Serum TMAO levels were measured, and acne severity was graded using the Global Acne Grading System (GAGS). Statistical analysis was performed using SPSS 20.0, with p-values &lt;0.05 considered significant. Results: Acne patients exhibited significantly higher serum TMAO levels (16.74 \u00b1 10.10 ng\/ml) compared to controls (13.11 \u00b1 4.28 ng\/ml, P=0.007). While no significant correlation was found between TMAO levels and acne severity, a weak negative trend was observed (P=0.062). Similarly, TMAO levels showed no significant correlation with body mass index (BMI) (P=0.933). Conclusion: This study identified elevated serum TMAO levels in acne vulgaris patients, suggesting a potential link between gut dysbiosis, diet, and acne pathogenesis. While these findings emphasize the role of systemic inflammation and microbiota, further research is necessary to establish causal relationships and to evaluate the impact of dietary and microbial interventions in acne management.<\/jats:p>","DOI":"10.5826\/dpc.1504a5486","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T13:22:13Z","timestamp":1761916933000},"page":"5486","source":"Crossref","is-referenced-by-count":2,"title":["Association Between Altered Gut Microbiota and Acne Vulgaris: A Comparative Study of Trimethylamine N-Oxide Levels in Patients and Healthy Controls"],"prefix":"10.5826","volume":"15","author":[{"given":"Eyl\u00fcl Ceren","family":"Bal Bayaz\u0131tl\u0131","sequence":"first","affiliation":[{"name":"Department of Dermatology, Akyurt State Hospital, Ankara"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fclhan Aksoy","family":"Sara\u00e7","sequence":"first","affiliation":[{"name":"Department of Dermatology, Ankara Bilkent City Hospital, Ankara"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anda\u00e7","family":"Uzdo\u011fan","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Ankara Bilkent City Hospital, Ankara"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onur","family":"Acar","sequence":"first","affiliation":[{"name":"Bursa Provincial Health Directorate, Bursa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice Busra","family":"Karaman","sequence":"first","affiliation":[{"name":"Department of Dermatology, Sincan State Hospital, Ankara"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alperen","family":"K\u00fclhan","sequence":"first","affiliation":[{"name":"Department of Dermatology, Ankara Bilkent City Hospital, Ankara"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ak\u0131n","family":"Akta\u015f","sequence":"first","affiliation":[{"name":"Department of Dermatology, Ankara Bilkent City Hospital, Ankara"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27750","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"10.5826\/dpc.1504a5486_ref1","doi-asserted-by":"crossref","unstructured":"Hou K, Wu ZX, Chen XY, et al. Microbiota in health and diseases. Signal Transduction and Targeted Therapy 2022 7:1. 2022;7(1):1-28. doi:10.1038\/s41392-022-00974-4. PMID: 35461318","DOI":"10.1038\/s41392-022-00974-4"},{"key":"10.5826\/dpc.1504a5486_ref2","doi-asserted-by":"crossref","unstructured":"Barko PC, McMichael MA, Swanson KS, Williams DA. The Gastrointestinal Microbiome: A Review. J Vet Intern Med. 2018;32(1):9-25. doi:10.1111\/JVIM.14875. PMID: 29171095","DOI":"10.1111\/jvim.14875"},{"key":"10.5826\/dpc.1504a5486_ref3","doi-asserted-by":"crossref","unstructured":"Manos J. The human microbiome in disease and pathology. APMIS. 2022;130(12):690-705. doi:10.1111\/APM.13225. PMID: 35393656","DOI":"10.1111\/apm.13225"},{"key":"10.5826\/dpc.1504a5486_ref4","doi-asserted-by":"crossref","unstructured":"Barrea L, Muscogiuri G, Pugliese G, et al. Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa). Nutrients. 2021;13(6):1997. doi:10.3390\/NU13061997. PMID: 34200594","DOI":"10.3390\/nu13061997"},{"key":"10.5826\/dpc.1504a5486_ref5","unstructured":"G\u0105tarek P, Ka\u0142u\u017cna-Czapli\u0144ska J. Trimethylamine N-oxide (TMAO) in human health. EXCLI J. 2021;20:301. doi:10.17179\/EXCLI2020-3239. PMID: 33746664"},{"key":"10.5826\/dpc.1504a5486_ref6","doi-asserted-by":"crossref","unstructured":"Canyelles M, Borr\u00e0s C, Rotllan N, Tondo M, Escol\u00e0-Gil JC, Blanco-Vaca F. Gut Microbiota-Derived TMAO: A Causal Factor Promoting Atherosclerotic Cardiovascular Disease? Int J Mol Sci. 2023;24(3):1940. doi:10.3390\/IJMS24031940\/S1. PMID: 36768264","DOI":"10.3390\/ijms24031940"},{"key":"10.5826\/dpc.1504a5486_ref7","doi-asserted-by":"crossref","unstructured":"Zhang Y, Wang Y, Ke B, Du J. TMAO: how gut microbiota contributes to heart failure. Translational Research. 2021;228:109-125. doi:10.1016\/J.TRSL.2020.08.007","DOI":"10.1016\/j.trsl.2020.08.007"},{"key":"10.5826\/dpc.1504a5486_ref8","doi-asserted-by":"crossref","unstructured":"Golonka RM, Xiao X, Abokor AA, Joe B, Vijay-Kumar M. Altered nutrient status reprograms host inflammation and metabolic health via gut microbiota. J Nutr Biochem. 2020;80:108360. doi:10.1016\/J.JNUTBIO.2020.108360. PMID: 32163821","DOI":"10.1016\/j.jnutbio.2020.108360"},{"key":"10.5826\/dpc.1504a5486_ref9","doi-asserted-by":"crossref","unstructured":"Koeth RA, Wang Z, Levison BS, et al. Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis. doi:10.1038\/nm.3145. PMID: 23563705","DOI":"10.1038\/nm.3145"},{"key":"10.5826\/dpc.1504a5486_ref10","doi-asserted-by":"crossref","unstructured":"Romano KA, Vivas EI, Amador-Noguez D, Rey FE. Intestinal microbiota composition modulates choline bioavailability from diet and accumulation of the proatherogenic metabolite trimethylamine-N-oxide. mBio. 2015;6(2). doi:10.1128\/MBIO.02481-14\/SUPPL_FILE\/MBO002152235SF6.TIF.","DOI":"10.1128\/mBio.02481-14"},{"key":"10.5826\/dpc.1504a5486_ref11","doi-asserted-by":"crossref","unstructured":"Pessemier B De, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut\u2013Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms. 2021;9(2):353. doi:10.3390\/MICROORGANISMS9020353. PMID: 33670115","DOI":"10.3390\/microorganisms9020353"},{"key":"10.5826\/dpc.1504a5486_ref12","doi-asserted-by":"crossref","unstructured":"Pink A, Anzengruber F, Navarini AA. Acne and hidradenitis suppurativa. British Journal of Dermatology. 2018;178(3):619-631. doi:10.1111\/BJD.16231. PMID: 29380349","DOI":"10.1111\/bjd.16231"},{"key":"10.5826\/dpc.1504a5486_ref13","doi-asserted-by":"crossref","unstructured":"Conforti C, Agozzino M, Emendato G, et al. Acne and diet: a review. Int J Dermatol. 2022;61(8):930-934. doi:10.1111\/IJD.15862. PMID: 34423427","DOI":"10.1111\/ijd.15862"},{"key":"10.5826\/dpc.1504a5486_ref14","doi-asserted-by":"crossref","unstructured":"Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Exp Dermatol. 2009;18(10):833-841. doi:10.1111\/J.1600-0625.2009.00924.X","DOI":"10.1111\/j.1600-0625.2009.00924.x"},{"key":"10.5826\/dpc.1504a5486_ref15","doi-asserted-by":"crossref","unstructured":"O\u2019Neill CA, Monteleone G, McLaughlin JT, Paus R. The gut-skin axis in health and disease: A paradigm with therapeutic implications. BioEssays. 2016;38(11):1167-1176. doi:10.1002\/BIES.201600008. PMID: 27554239","DOI":"10.1002\/bies.201600008"},{"key":"10.5826\/dpc.1504a5486_ref16","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Pellicer P, Navarro-Moratalla L, N\u00fa\u00f1ez-Delegido E, Ruzafa-Costas B, Ag\u00fcera-Santos J, Navarro-L\u00f3pez V. Acne, Microbiome, and Probiotics: The Gut\u2013Skin Axis. Microorganisms 2022, Vol 10, Page 1303. 2022;10(7):1303. doi:10.3390\/MICROORGANISMS10071303. PMID: 35889022","DOI":"10.3390\/microorganisms10071303"},{"key":"10.5826\/dpc.1504a5486_ref17","doi-asserted-by":"crossref","unstructured":"Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol. 1997;36(6):416-418. doi:10.1046\/J.1365-4362.1997.00099.X. PMID: 9248884","DOI":"10.1046\/j.1365-4362.1997.00099.x"},{"key":"10.5826\/dpc.1504a5486_ref18","doi-asserted-by":"crossref","unstructured":"Cantero MA, Guedes MRA, Fernandes R, Lollo PCB. Trimethylamine N-oxide reduction is related to probiotic strain specificity: A systematic review. Nutr Res. 2022;104:29\u201335. doi:10.1016\/j.nutres.2022.04.001. PMID: 35588611","DOI":"10.1016\/j.nutres.2022.04.001"},{"key":"10.5826\/dpc.1504a5486_ref19","doi-asserted-by":"crossref","unstructured":"El Hage R, Al-Arawe N, Hinterseher I. The role of the gut microbiome and trimethylamine oxide in atherosclerosis and age-related disease. Int J Mol Sci. 2023;24(3):2399. doi:10.3390\/ijms24032399. PMID: 36768722","DOI":"10.3390\/ijms24032399"},{"key":"10.5826\/dpc.1504a5486_ref20","doi-asserted-by":"crossref","unstructured":"David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature 2013 505:7484. 2013;505(7484):559-563. doi:10.1038\/nature12820. PMID: 24336217","DOI":"10.1038\/nature12820"},{"key":"10.5826\/dpc.1504a5486_ref21","doi-asserted-by":"crossref","unstructured":"Singh RK, Chang HW, Yan D, et al. Influence of diet on the gut microbiome and implications for human health. Journal of Translational Medicine 2017 15:1. 2017;15(1):1-17. doi:10.1186\/S12967-017-1175-Y. PMID: 28388917","DOI":"10.1186\/s12967-017-1175-y"},{"key":"10.5826\/dpc.1504a5486_ref22","doi-asserted-by":"crossref","unstructured":"Coutinho-Wolino KS, Ludmila LFM, de Oliveira Leal V, Mafra D, Stockler-Pinto MB. Can diet modulate trimethylamine N-oxide (TMAO) production? What do we know so far? European Journal of Nutrition 2021 60:7. 2021;60(7):3567-3584. doi:10.1007\/S00394-021-02491-6. PMID: 33533968","DOI":"10.1007\/s00394-021-02491-6"},{"key":"10.5826\/dpc.1504a5486_ref23","doi-asserted-by":"crossref","unstructured":"Hitosugi N, Yamashita A, Matsushita T. Dysbiosis of gut microbiota and acne vulgaris: The role of short-chain fatty acids gut in pathogenesis. Clin Dermatol J. 2020;5(3):000218. doi:10.23880\/cdoaj-16000218","DOI":"10.23880\/CDOAJ-16000218"},{"key":"10.5826\/dpc.1504a5486_ref24","doi-asserted-by":"crossref","unstructured":"Xiao X, Hu X, Yao J, et al. The role of short-chain fatty acids in inflammatory skin diseases. Front Microbiol. 2023;13:1083432. doi:10.3389\/fmicb.2022.1083432. PMID: 36817115","DOI":"10.3389\/fmicb.2022.1083432"},{"key":"10.5826\/dpc.1504a5486_ref25","doi-asserted-by":"crossref","unstructured":"Meixiong J, Ricco C, Vasavda C, Ho BK. Diet and acne: A systematic review. JAAD Int. 2022;7:95-112. doi:10.1016\/J.JDIN.2022.02.012. PMID: 35373155","DOI":"10.1016\/j.jdin.2022.02.012"},{"key":"10.5826\/dpc.1504a5486_ref26","doi-asserted-by":"crossref","unstructured":"Rygu\u0142a I, Pikiewicz W, Kamini\u00f3w K. Impact of Diet and Nutrition in Patients with Acne Vulgaris. Nutrients 2024, Vol 16, Page 1476. 2024;16(10):1476. doi:10.3390\/NU16101476. PMID: 38794714","DOI":"10.3390\/nu16101476"}],"container-title":["Dermatology Practical &amp; Conceptual"],"original-title":[],"link":[{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/download\/5486\/3250","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/download\/5486\/3609","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/download\/5486\/3250","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T14:35:20Z","timestamp":1765463720000},"score":1,"resource":{"primary":{"URL":"https:\/\/dpcj.org\/index.php\/dpc\/article\/view\/5486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.5826\/dpc.1504a5486","relation":{"has-manifestation":[{"id-type":"other","id":"1-81-5486-g3250","asserted-by":"subject"},{"id-type":"other","id":"1-81-5486-g3609","asserted-by":"subject"}],"is-part-of":[{"id-type":"doi","id":"10.5826\/dpc.1504a%a","asserted-by":"subject"}]},"ISSN":["2160-9381"],"issn-type":[{"value":"2160-9381","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]},"article-number":"21"}}