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As a methyl donor, betaine increases overall methylation levels and regulates abnormal DNA methylation [by regulating cytosine-phosphate-guanine (CpG) methylation in the promoter region of PPAR and hepcidin antimicrobial peptide genes associated with lipogenesis and iron metabolism]

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312 Lipotoxicity impairs insulin signaling, induces oxidative damage, promotes inflammation and fibrosis, 313 which is thought to be related to the progression of MAFLD patients from simple steatosis to NASH, hepatic fibrosis, and hepatocellular carcinoma

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