INS and Impaired glucose tolerance: Animal studies also found that TMAO may exacerbate impaired glucose tolerance and hyperglycemia by blocking the hepatic insulin signaling pathway and causing inflammation in adipose tissue (131), whereas a decrease of plasma TMAO could reduce plasma glucose and insulin resistance in mice by inhibiting the main TMAO-generating enzyme FMO3 (flavin-containing monooxygenase-3) (132).