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Recent human trials have also shown that FMT can lower intestinal permeability and hepatic steatosis in MASLD patients, which is in line with animal investigations (208)

It has been reported that FGF21 levels are significantly elevated in MASLD, particularly in MASH patients, and this increase may reflect hepatic stress and damage [235, 236]

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The novel missense SNPs potentially linked with resistance should be used as targets in high-throughput molecular assays, to support surveillance and assist functional work to understand and validate underlying mechanisms associated with resistant phenotypes