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L-carnitine itself, as well as several of its metabolites, including GBB, crotonobetaine, and trimethylamine-n-oxide (TMAO), have been associated with cerebrovascular dysfunction and cardiovascular disease (Figure 1), which is then absorbed into the bloodstream and converted to TMAO in the liver ( APOE -dependent differences in the gut microbiota in both humans and APOE-TR mice ( APOE genotypes on the L-carnitine system, upon which FAO is largely dependent, have not yet been examined either