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Although substantial evidence suggests that an increase in the level of TMAO is associated with the risk of cardiovascular diseases including atherosclerosis, chronic kidney disease, and hypertension, the direct effect of TMAO on vascular endothelial function remains unclear

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The enzymatic antioxidant system predominately comprises superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX), and the non-enzymatic antioxidant system is classified as endogenous and exogenous antioxidants, the former including GSH, uric acid, transferrin, and the latter encompassing parts of vitamins, α-tocopherol, α-lipoic acid, and others ( in vivo , but oxidative stress occurs if it is insufficient to resist excessive ROS