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This enzyme metabolizes some dietary ingredients, such as choline, and other choline-containing compounds (phosphatidylcholine/lecithin, phosphocholine, sphingomyelin, etc .), betaine, and L-carnitine and its metabolite -butyrobetaine (GBB), releasing TMA after the cleavage of the carbon (C)nitrogen (N) bond of choline/carnitine (Zhu et al., 2014)

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Thus, manipulation of the microbiome through diet, probiotics, prebiotics and other medications is a viable line of research for the treatment of liver diseases, including MASLD

diff , but more research is needed to determine the optimal strain and combinations for specific patients