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This was not a randomized control trial, rather we recruited participants already taking these medications, additionally we did not use a placebo for alcohol administration

Dehydration compounds this effect significantly

Some studies have shown that metformin can markedly reduce the levels of ghrelin, insulin and C-peptide in MASLD patients, but the improvement of liver fibrosis and liver inflammation is not significant (243,244)

Less frequent dosing should be considered for hepatically impaired or elderly patients (see PRECAUTIONS: Impaired Hepatic Function, and Use in the Elderly)

This is a reduction in the fat around organs