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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

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