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Its ability to cross the blood-brain barrier allows it to affect brain metabolism directly
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The two groups were similar in smoking history, sunlight exposure, and alcohol use

Elevated blood TMAO levels cause an imbalance in cholesterol homeostasis which leads to influenced macrophages, which in turn causes foam cell development and atherosclerotic plaques [68, 69, 71]

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54 , 55 Thus, TH has both direct and indirect roles in DNL, a key metabolic pathway in the liver that has been implicated in the development of MASLD