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The estrobolome may modulate circulating estrogen levels and thereby indirectly influence glucose metabolism across the cycle
Protein-bound uremic toxins (IS, pCS, PAGln) accumulate exponentially as eGFR declines below 60 mL/min/1.73 m 2 due to saturable OAT1/3-mediated tubular secretion (113, 167), with patients at eGFR 30 exhibiting 510 higher IS than those at eGFR 90reflecting clearance impairment rather than unique pathogenic mechanisms

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doi: 10.1038/srep07456 183 ChenJYangXLiQMaJLiHWangLet al

A 2025 study in Biomolecules found that NNMT inhibitor treatment "reduces body weight, white adipose tissue mass, total cholesterol, and adipocyte size in obese mice." These changes suggest cardiovascular benefit beyond simple weight loss
