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It is now considered to be an active osteogenic process of vascular cells (mainly VSMCs), similar to osteoblast formation, and is defined by the stages of osteogenic differentiation, matrix maturation, and matrix mineralization ( in vitro study found that TMAO can also upregulate the NF-B signaling pathway to promote adipogenic differentiation and inhibit the osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) ( Another study found that in the aorta of fish protein-fed mice, the atherosclerotic plaque area and degree of calcification were significantly higher than that of casein- or-soy protein-fed mice, but there were no significant changes in lipid-related content

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In contrast to the potential dangerous effects in the acceleration of atherosclerosis, mixed results have been reported with L-carnitine supplementation in the immediate setting following an acute myocardial infarction (AMI)

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