Baltacıoğlu A., Özpınar A.
May Institute , Massachusetts, Amerika Birleşik Devletleri, 27 - 30 Nisan 2026, (Yayınlanmadı)
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Yayın Türü:
Bildiri / Yayınlanmadı
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Basıldığı Şehir:
Massachusetts
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Basıldığı Ülke:
Amerika Birleşik Devletleri
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Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli:
Evet
Özet
TMAO and Its Precursors in Bladder Cancer Quantified by LC–MS/MS
Aleyna Baltacıoğlu1, Osman Acar5, Ceyda Sönmez1, Yeşim Sağlıcan2, Ömer Burak Argun3, Ali Rıza Kural3, Ümit İnce2, Muhittin Abdülkadir Serdar1,4,5, Aysel Özpınar1,5
1Department of Biochemistry and Molecular Biology, Graduate School of Science, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
2Department of Pathology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
3Department of Urology, Acibadem Mehmet Ali Aydinlar University Medical Faculty, Istanbul, Turkey
4Acibadem Labmed Clinical Laboratories, Istanbul, Turkey
5Department of Medical Biochemistry, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
Non–muscle-invasive bladder cancer (NMIBC) requires lifelong invasive surveillance due to its high recurrence risk, resulting in repeated cystoscopic examinations and substantial patient burden. In addition to discomfort and procedure-related risks, frequent follow-up increases healthcare costs and may still miss early signs of recurrence. These challenges highlight the need for reliable, easily measurable, non-invasive biomarkers that can complement cystoscopy by improving risk stratification, supporting earlier detection of recurrence/progression, and enabling more personalized surveillance schedules. Trimethylamine-N-oxide (TMAO) is a gut microbiota–derived metabolite produced from dietary choline, carnitine, and betaine and has been linked to inflammation and carcinogenesis; however, its relevance to bladder cancer remains unclear. In this study, we quantified serum TMAO and its dietary precursors in 50 male patients with early-stage NMIBC (25 pTa, 25 pT1) and 52 age-matched healthy controls using LC–MS/MS. Group differences were assessed using non-parametric tests, and associations were evaluated using Spearman’s correlation. Diagnostic performance was examined by receiver operating characteristic (ROC) analysis, and independent predictors were assessed using multivariable logistic regression. Serum TMAO, carnitine, and choline concentrations were significantly higher in NMIBC patients than in controls, whereas betaine showed a non-significant trend toward higher levels. Tumor stage correlated most strongly with TMAO, followed by carnitine and choline. In ROC analysis, TMAO showed the highest individual diagnostic performance, while carnitine and choline provided more balanced sensitivity and specificity. Betaine demonstrated limited discriminatory ability. In multivariable logistic regression, TMAO, carnitine, and choline remained independent predictors of bladder cancer, whereas betaine was not significant. A composite risk score based on these four metabolites showed strong discriminative performance. Overall, serum TMAO, carnitine, and choline appear promising as non-invasive biomarkers for early-stage bladder cancer and should be evaluated in larger cohorts, ideally alongside microbiome and genomic data to better understand the TMAO axis.
Keywords: Biomarkers, Trimethylamine-N-oxide Bladder cancer, LC–MS/MS, Omics, Carnitine, Choline, Betaine