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TMAO has a high turnover rate, with more than 90% excreted in the urine after being metabolized by the kidney ( Figure 1 Studies have found that high levels of TMAO are closely related to the occurrence of atherosclerosis, HF, hypertension, and other CVDs ( Figure 2 )

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The guideline identifies specific populations in which dietary supplementation may be necessary, such as women who are pregnant or lactating and adults older than 50

In conclusion, the role of betaine in rodents with NAFLD seems to involve multiple metabolic pathways, and its important role is to regulate the expression of genes involved in fatty acid and lipid metabolism, thus improving the development of liver steatosis