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Oxidative stress affects numerous molecular pathways, including inhibition of the cystine/glutamate antiporter system, decreased expression of GPX4, disruption of iron homeostasis and lipid peroxidation, which is a major driver of ferroptosis activation (54)

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If the metabolic stress continues, it can progress to Non-Alcoholic Steatohepatitis (NASH) , which involves active inflammation and liver cell injury