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This pathway begins with the activation of PGC-1 in the cytoplasm, which subsequently stimulates the expression of a series of nuclear transcription factors, including nuclear respiratory factor-1, nuclear respiratory factor-2, and estrogen-related receptor-, among others (Tang, 2016

These findings underscore the differential response in TMAO levels to dietary fibers among individuals with varying meat consumption patterns, suggesting a potential approach for targeted dietary strategies to modulate TMAO metabolism

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The study also did not assess cross reactivity of statins, and statin rechallenge was only described in one case, the authors did not report whether the patient was in the hepatocellular or cholestatic liver injury cohort