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Due to TMAO excretion in urine [56, 57], in chronic renal disease patients, TMAO elimination from the body fails, causing elevation of its plasma concentration [78]

Moreover, dietary supplementation with TMAO significantly decreased the expression of both enteral cholesterol transporters Niemann-Pick C1-like1 (Npc1L1), which transports cholesterol into enterocytes from the intestinal lumen, and ABCG5/8, which transports cholesterol out of enterocytes into the gut lumen ( The TMA/FMO3/TMAO pathway driven by gut microbiota is also an important regulator of lipid metabolism (Warrier et al., 2015)