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Dietary precursors, such as choline and carnitine, are metabolized into trimethylamine (TMA) by gut microbiota via specific genes, including members of the choline utilization gene cluster (Cut)C/D. Host hepatic flavin monooxygenases (FMOs) oxidize TMA into TMAO, which promotes metabolic and functional changes in the host including cardiovascular and renal end-organ damage.
