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Second, although numerous observational studies have shown causal associations between TMAO and cardiovascular, kidney, neurological, and metabolic diseases, due to the inherent limitations of statistical methods (bias due to confounding factors and reverse causality), and the causal relationship between TMAO and human diseases still requires validation through multicenter, multi-ethnic randomized controlled trials

Diabetologia 2012

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Like, I'm gonna say, like, as a person who is, like, just sitting here, like, watching it happen, I'm like, it's kind of cruel