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In particular, the metabolism of dietary substrates such as choline and l-carnitine to trimethylamine (TMA) and subsequently to trimethylamine oxide (TMAO) by a hepatic enzyme flavin-containing monooxygenase 3 (FMO3) is of interest due to the strong associations of high circulating TMAO concentrations with the risk of numerous metabolic diseases and the risk of death from heart failure [4,5,6]

In addition, diet can trigger inflammatory processes that may lead to dysfunction in the nervous system and other body systems that may ultimately harm sleep

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6 Previous studies have also found elevated circulating concentrations of erythritol precede coronary heart disease, 25,26 associated with diabetes, 27,28 obesity, 5 and arterial stiffness, 29 and may therefore be a marker of impaired metabolism

Graphical abstract Access this article Similar content being viewed by others Data availability The data that support the findings of this study are available from the corresponding author upon reasonable request

The multiple linear regression models included covariates such as sex, age, physical activity, alcohol intake, body mass index, estimated glomerular filtration rate, diabetes, hypertension, and dyslipidemia, and included the interaction between the smoking factors and sex