On the one hand, TMAO promotes IR by regulating glucose metabolism and increasing the levels of CCL2 and inflammatory cytokine C-C motif chemokine ligand 2; on the other hand, it exacerbates hepatic steatosis by reducing the conversion of cholesterol into bile acids and inhibiting farnesoid X receptor (FXR) signaling (86). This evidence concerns the gene NR1H4 and Hepatic steatosis.