FIGURE 2.

Products of vitamin, phytochemical and purine co-metabolism associated with obesity and diabetes via metabolomics studies. Intestinal microorganisms catalyze the conversion of dietary choline and carnitine into TMA with a direct effect on the intestinal mucose (increased oxidative stress) and is the substrate for the hepatic production of TMAO (associated with cardiovascular disease risk) and TMA. Choline may escape microbial degradation and convert into betaine and further products [i.e., dimethylglycine (DMG)] by mammalian mitochondrial pathways in the liver and kidney where they have an detrimental osmotic effects. For most of the host microbial co-metabolites associated with the diabese phenotype, the eventual role in glucose and lipid metabolism remains unknown. OGTT, Oral glucose tolerance test; SAH and SAM, S-adenosylmethionine to S-adenosylhomocysteine (methionine cycle).