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The consumption of acetyl-CoA in irreversible metabolic pathways, i.e., lipoic acid and citrate synthesis within the mitochondria followed by biosynthetic processes within the cytosol (Figure 1), drives the process and maintains the mitochondrial content of acetyl-CoA within a safe range

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Thus, while acute LC supplementation may confer immediate physiological benefits, chronic elevations in TMAO levels warrant careful risk evaluation due to their association with adverse cardiovascular outcomes, particularly in vulnerable populations