Abstract

Excessive consumption of diets high in sugars and saturated fat, frequently known as western diet (WD), may lead to obesity and metabolic syndrome. Recent evidence shows that WD-induced obesity impairs cardiac function, but the underlying mechanisms are not fully understood. Trimethylamine N-oxide (TMAO), a gut microbiota-dependent metabolite of specific dietary nutrients, has emerged as a key contributor to cardiovascular disease pathogenesis. We tested the hypothesis that elevated circulating TMAO levels contribute to cardiac dysfunction in WD-induced obesity. CD1 mice were fed a normal diet (ND) or a WD, without or with 1.0% 3,3-Dimethyl-1-butanol (DMB, an inhibitor of trimethylamine formation) in drinking water for 8 weeks. Compared with mice fed a ND, mice fed a WD showed a significant increase in body weight and dyslipidemia, and had markedly higher plasma TMAO levels at the end of the feeding protocol. Echocardiography revealed that cardiac systolic and diastolic function was impaired in mice fed a WD. DMB treatment had no effects on body weight and dyslipidemia, but significantly reduced plasma TMAO levels and prevented cardiac dysfunction in mice fed a WD. In addition, mice fed a WD had elevated expression of pro-inflammatory cytokines tumor necrosis factor-α and interleukin IL-1β, decreased expression of anti-inflammatory cytokine IL-10, and increased interstitial fibrosis in the hearts, all of which were prevented by DMB treatment. Notably, DMB treatment also reduced plasma TMAO levels in mice fed a ND but did not alter other parameters. These results suggest that consumption of a WD increases circulating TMAO levels, which lead to cardiac inflammation and fibrosis, contributing to cardiac dysfunction. Interventions that reduce circulating TMAO levels may be a novel therapeutic strategy for prevention and treatment of WD-induced cardiac dysfunction.

Highlights

  • The prevalence of obesity is recognized worldwide as a major health problem and has reached epidemic proportions, affecting both genders and all ages (Flegal et al, 2012; Head, 2015)

  • The major findings of this study are as follows: (1) compared with mice fed a normal diet (ND), mice fed a western diet (WD) for 8 weeks develop obesity and dyslipidemia, and have higher plasma Trimethylamine N-oxide (TMAO) levels; (2) treatment with DMB, an inhibitor of TMA formation, prevents WD-induced increases in plasma TMAO levels without effects on body weight and dyslipidemia; (3) mice fed a WD for 8 weeks exhibit cardiac dysfunction, which is prevented by treatment with DMB; (4) mice fed a WD for 8 weeks have interstitial fibrosis and inflammation in the heart, which are prevented by treatment with DMB

  • These data suggest that WD feeding increases plasma TMAO levels, which leads to elevated inflammation and interstitial fibrosis in the heart, contributing to cardiac dysfunction

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Summary

Introduction

The prevalence of obesity is recognized worldwide as a major health problem and has reached epidemic proportions, affecting both genders and all ages (Flegal et al, 2012; Head, 2015). Obesity is a major risk factor for heart failure (Kenchaiah et al, 2002; Baena-Díez et al, 2010). Several cohort studies of heart failure patients have revealed that nearly 35% of those patients are obese and that 60% are overweight (Gustafsson et al, 2005). Experimental studies have recently shown that WD-induced obesity in mice impairs cardiac function (Carbone et al, 2015; Kesherwani et al, 2015), but the underlying mechanisms are not fully understood

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