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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2026, Vol. 31 ›› Issue (6): 774-781.doi: 10.12092/j.issn.1009-2501.2026.06.006

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Trimethylamine-N-oxide and vascular remodeling in patients with diabetes

Jun WU(), Yuwei SONG, Hongbiao LIANG, Juan FENG()   

  1. Department of Integration Chinese and Western Medicine, School of Basic Medical Sciences, Peking University; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University; Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University, Beijing 100191, China
  • Received:2025-04-17 Online:2026-06-26 Published:2026-07-06
  • Contact: Juan FENG E-mail:20101222502@stu.pku.edu.cn;juanfeng@bjmu.edu.cn

Abstract:

Vascular remodeling represents a key pathophysiological basis for the onset and progression of diabetes-related cardiovascular and cerebrovascular diseases. In recent years, trimethylamine-N-oxide (TMAO) has attracted considerable attention as a novel risk factor implicated in various diseases. This review systematically summarizes the regulatory effects of TMAO on the intima, media, and adventitia of blood vessels. In particular, we highlight how TMAO contributes to pathological vascular remodeling—such as intimal hyperplasia, calcification, and fibrosis—by promoting vascular smooth muscle cell phenotypic switching, fibroblast differentiation, and abnormal alterations in structural proteins. Moreover, we focus on the complex interplay between TMAO and vascular remodeling under diabetic conditions, emphasizing the enhancement of advanced glycation end products, inflammation, and oxidative stress. Based on recent findings, lowering TMAO levels or blocking its signaling pathways may offer promising strategies for intervening in vascular remodeling, providing novel insights into the prevention and treatment of diabetic vascular complications.

Key words: trimethylamine-N-oxide, vascular remodeling, diabetes, cardiovascular disease, gut microbiota

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