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Commun Biol 4(1):465

This theory includes various factors, including lipid accumulation, IR, adipose tissue dysfunction, diet and nutrition, immune responses, changes in the gut microbiome, and genetic and epigenetic factors [21]

Recent studies have indicated that the glutamine (Gln) metabolite -ketoglutarate (-KG) can undergo conversion to acetyl-CoA, a process that plays an integral role in the metabolic process of fatty acids

In addition, in vitro studies have shown that recombinant TTR amyloid aggregates are internalized by human cardiac fibroblasts, which subsequently secrete IL-6 and IL-8, providing mechanistic evidence that TTR aggregates can trigger inflammatory responses in cardiac cells [77]

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