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Fish is rich in TMAO, a randomized controlled trial in young men showed that fish yields higher circulating and urinary concentrations of TMAO, TMA, and DMA than eggs, beef, or fruit control ( The Link Between TMAO and MAFLD In recent years, due to the correlation between TMAO and cardiovascular disease (CVD) ( Obesity is a major risk factor for MAFLD, free fatty acids and metabolites released by adipocytes and cytokines secreted by macrophages in adipose tissue contribute to the of development MAFLD ( There is a close relationship between IR/diabetes and MAFLD, the mechanisms by which IR promotes MAFLD include changes in rates of adipose tissue lipolysis and de novo lipogenesis, impaired mitochondrial fatty acid -oxidation (FAO), changes in fat distribution, and alterations in levels of adipokines and cytokines ( Recently, a clinical study conducted by found that in obese patients, there is a positive correlation between TMAO levels and MAFLD histologic features

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