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In NAFLD/MASLD, antioxidant approaches (vitamin E, glutathione) show modest biochemical and histological benefit mainly in earlier, non-cirrhotic stages, but robust outcome data in advanced disease are lacking ( Our finding that treatment duration did not influence outcomes across multiple analytic approaches (correlation analysis, stratified analysis, multivariate regression, machine learning) has important clinical implications

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In this situation an outside or exogenous source of reduced glutathione may be needed for some time to resuscitate the compromised methionine cycle and allow the normal formation of glutathione

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