In T2DM-CKD patients, elevated serum TMAO levels showed positive correlations with markers of intestinal permeability (zonulin), endotoxin lipopolysaccharide (LPS), and serum biomarkers of inflammatory and endothelial dysfunction (IL-6, TNF-α, ET-1) (Al-Obaide et al. Here, HP is linked to type 2 diabetes mellitus.