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There is a close relationship between IR/diabetes and MAFLD, the mechanisms by which IR promotes MAFLD include changes in rates of adipose tissue lipolysis and de novo lipogenesis, impaired mitochondrial fatty acid -oxidation (FAO), changes in fat distribution, and alterations in levels of adipokines and cytokines (Tilg et al., 2017

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Besides the direct advantage in terms of ATP synthesized from fatty acids, FAO is also relevant in managing oxidative stress derived from the electron transport chain activity

Ammonia levels were reduced to normal in all cases, and no symptoms consistent with encephalopathy were reported

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