Introduction Trimethylamine N-oxide (TMAO), a gut microbiota metabolite from dietary
phosphatidylcholine, is involved in the pathogenesis of atherosclerosis and cardiovascular
diseases. Psoriasis is associated with increased cardiovascular risk that is not captured
by traditional biomarkers. The aim of the present study was to assess TMAO concentration
in psoriasis and evaluate the relationship between TMAO and cardiovascular risk in
psoriatic patients. Methods In 72 patients with psoriasis and 40 age- and sex-matched
non-psoriatic controls, we evaluated fasting plasma TMAO, measured by high-performance
liquid chromatography, and cardiovascular risk assessed by various scoring systems
such as Framingham, QRISK2, AHA/ACC, and Reynolds risk scores. Results In patients
with psoriasis, TMAO concentration was significantly higher than in the control group
(195.68 [133.54-332.58] ng/ml versus 126.06 [84.29-156.88] ng/ml, respectively; p
< 0.001). Plasma TMAO concentration was significantly correlated with age, total cholesterol,
triglycerides, systolic and diastolic blood pressure. Furthermore, the receiver-operating
characteristic (ROC) and multiple regression analysis showed that TMAO is an independent
predictor of cardiovascular risk. Conclusion TMAO is a valuable candidate for biomarker
and a translational link between dysbiosis and atherosclerosis in psoriasis.
