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Figure 1 3.1 Metabolic dysregulation: TMAO and short-chain fatty acids 3.1.1 Trimethylamine N-oxide Dietary choline, L-carnitine, and phosphatidylcholine (abundant in red meat, eggs) are metabolized by gut bacteria (e.g., Clostridium , Enterococcus ) to trimethylamine (TMA), which is oxidized to TMAO by hepatic flavin monooxygenases (FMO3) ( 3.1.2 Short-chain fatty acids Fermentation of dietary fiber by Roseburia , Faecalibacterium prausnitzii , and Akkermansia muciniphila produces acetate, propionate, and butyrate