Trimethylamine N oxide (TMAO) is a small molecule produced in humans primarily by the gut liver axis and has become an important biomarker, and possible mediator, of cardiometabolic and renal disease. Dietary choline, phosphatidylcholine ( TMAO biosynthesis. L carnitine and choline are derived from the diet Download Scientific Diagram The Intricate Gut Heart Connection; The Role of Gut Microbiota in the Pathogenesis of Cardiovascular Disease Gut Microbiota and Ischemic Stroke: The Role of Trimethylamine N Oxide