Endpoint: mixed — mouse atherosclerosis + human challenge biomarker + prospective angiography-cohort MACE.
NOT egg-specific: L-carnitine (abundant in red meat) is, like choline, a dietary trimethylamine that gut microbiota metabolize to TMA/TMAO. Dietary L-carnitine accelerated atherosclerosis in mice via the same TMAO route; in a human oral L-carnitine challenge, omnivores produced far more TMAO than vegans/vegetarians (microbiota-composition-dependent), and plasma carnitine predicted CVD risk only in subjects with concurrently high TMAO.
relevance_note: not a choline/egg primary, but the analogous foundational demonstration that the SAME TMA/TMAO route from a different dietary trimethylamine precursor drives atherosclerosis, and that habitual diet (via gut-microbiota composition) gates the response — included per brief as directly related mechanistic context, not as egg-specific evidence.