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TMAO can inhibit the activation of FXR by changing the size of the bile acid pool, which may weaken or inhibit the beneficial effect of FXR, affect the glucose metabolism of the host, and promote the occurrence and development of insulin resistance and NAFLD

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Residual L-carnitine production in a hypomorphic allele may provide intracellular L-carnitine levels high enough to protect against -BB-related toxicity, potentially caused by competitive inhibition of L-carnitine transport into the cells

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