In a more recent study, Ding et al. found an activation of nuclear receptor farnesoid X receptor (FXR) and small heterodimer partner (SHP) mediated by TMAO that suppresses CYP7A1 expression and ultimately inhibits bile acid synthesis, increasing fat mass, serum lipid concentrations and atherosclerosis [48]. The gene discussed is NR1H4; the disease is atherosclerosis.