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The association between smoking and MASLD is underpinned by shared pathological mechanisms, particularly insulin resistance and visceral fat accumulation, which are central to the metabolic syndrome (MetS)

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Experiments in cell culture, involving both adipocytes and skeletal muscle cells, have shown that ceramides inhibit insulin-stimulated glucose uptake by blocking translocation of GLUT4 to the plasma membrane as well as interfering with glycogen synthesis

Phase 3 trials of tirzepatide did not exclude participants taking antioxidant supplements, and subgroup analyses showed no difference in adverse events or efficacy between supplement users and non-users

HINE, C.H