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. 2021 Jun 16;12:651926. doi: 10.3389/fphar.2021.651926

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Copyright © 2021 Li, Gao, Siqin, He, Zhang, Meng, Zhang, Zhang and Li.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The role of gut microbiota in cardiovascular disease and flavonoid metabolism. The GM produces TMA by ingesting choline (such as choline, phosphatidylcholine and l–carnitine) from food. TMA enters the liver through the hepatointestinal circulation, and forms TMAO through the oxidation of flavin monooxygenase, then enters the systemic circulation. Circulating TMAO levels increase, causing foam cells and platelets to accumulate, while affecting cholesterol transport, thereby promoting atheromatous plaque formation.