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Recent metabolomics and animal studies showed that TMAO, an intestinal microbiota-dependent metabolite formed from dietary trimethylamine-containing nutrients such as phosphatidylcholine (PC), choline and carnitine, is linked to coronary artery disease pathogenesis, only in the presence of TMA/TMAO generation and intact gut microbiota 35,46

Table 1 Comparison of melatonin synthesis in vertebrates and microorganisms

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