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A key aspect of this crosstalk is the livers secretion of hepatokines, such as fibroblast growth factor 21 (FGF21) and growth differentiation factor 15 (GDF15), which increase insulin sensitivity, 191 promote mitochondrial integrity in cardiomyocytes via the AMPK/FOXO3/SIRT3 signaling axis, 192 and suppress renal fibrosis

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There is evidence that BCAAs can promote EC dysfunction by increasing oxidative stress and inflammation, but the specific enzymes, transporters, and pathways involved as well as the context-dependent effects require further investigation to fully elucidate their contribution to atherosclerosis development

(Maywood ) 62 HanE