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Moreover, microbial transplantation studies in germ-free mice with human commensals containing a functional (but not a deletion mutant) microbial cutC gene (responsible for cholineTMA transformation) (23) and genetic manipulation (both gain of function and loss of function) of host hepatic flavin monooxygenase 3 have been shown to modulate host TMAO levels, platelet responsiveness, and thrombosis potential in vivo (24)

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Another pathway through which polyphenols can increase insulin sensitivity is by activating AMP-activated protein kinase (AMPK), an essential regulator of energy metabolism (Xie et al., 2023)