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any decision to use NAC for NAFLD should be specialist-led

Given the fairly short half-life of unbound IGF-1 in serum (i.e., 510 min), binding to an IGF binding protein (IGFBP-3 is the most prevalent) in serum or in ECM increases IGF-1 half-life to around 25 min (Allard and Duan, 2019), leading to the production of phosphatidylinositol 3,4,5-trisphosphate (PIP3) (O'Neill et al., 2015)

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols guidelines