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Variable selection based on second-order Akaike information criterion are performed using R (29) function dredge in package MuMIn (30)

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However, notably, TMAO also exerts protective effects by activating the Nrf2 pathway, promoting Nrf2 dissociation from Keap1 and nuclear translocation, thereby inducing antioxidant genes (HO-1, NQO1, CAT) to reduce ROS accumulation and restore antioxidant enzyme activityunderscoring Nrf2s dual regulatory role in oxidative stress (Zou et al., 2024)