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Ammonia levels were reduced to normal in all cases, and no symptoms consistent with encephalopathy were reported

There is a close relationship between IR/diabetes and MAFLD, the mechanisms by which IR promotes MAFLD include changes in rates of adipose tissue lipolysis and de novo lipogenesis, impaired mitochondrial fatty acid -oxidation (FAO), changes in fat distribution, and alterations in levels of adipokines and cytokines (Tilg et al., 2017

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Ethics declarations Ethics approval and consent to participate The animal protocol was approved and all the experimental procedures were supervised by the Ethics Committee of the Third Military Medical University (SYXK20170002)

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