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In fact, MAFLD is a metabolic liver disease that associated with obesity, insulin resistance (IR), diabetes, hypertension, hyperlipidaemia, and other metabolic disorders (Younossi, 2019)

2019) Germ-free and antibiotic-treated animal models have been shown to lack the capacity for TMAO production, thus providing evidence for the role of the microbiome in the metabolism of carnitine to TMA and TMAO