Elevated plasma TMAO levels have been associated with alterations in reverse cholesterol transport, an increase in scavenger receptors, subsequent fat accumulation in foam cells, and the overexpression of inflammatory markers, including tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP), all of which promote cardiovascular disease [28]. This evidence concerns the gene TNF and cardiovascular disorder.