NPPB and diabetes mellitus: Elevated TMAO levels were associated with significantly increased HR after adjusting for risk factors (age, sex, smoking, SBP, diabetes, HDL, LDL, eGFR, and NTproBNP) levels (Q4 vs. Q1: HR 1.78, 95% CI: 1.12–2.82) (Supplementary Fig. 2b), which is consistent with a previous study26.