Search Results (4,865)

Background/Objectives: Multiple chemical sensitivity (MCS) is a complex environmental illness characterized by intolerance to various environmental chemicals, affecting multiple organ systems. Despite its prevalence, MCS remains poorly understood, with limited recognition by the World Health Organisation amid challenges in diagnosis due to symptom heterogeneity. This study aimed to investigate the oxidative stress status in patients diagnosed with MCS compared to healthy controls, focusing on plasma and erythrocyte markers. Methods: Blood samples from 40 MCS patients and 40 controls were analyzed for lipid peroxidation (LPO), total antioxidant activity (TAA), adenosine triphosphate (ATP), and antioxidant enzyme activities, alongside glutathione cycle components. Results: Results revealed no significant differences in plasma LPO or TAA between groups, with a reduction in 61% ATP levels in MCS subjects. However, erythrocyte analysis showed reduced levels of glutathione (GSH) and total glutathione in MCS patients. Glutathione peroxidase (GPx) activity also decreased by 15% in erythrocytes of MCS patients, suggesting increased hydrogen peroxide detoxification at the expense of oxidation of GSH to glutathione disulfide (GSSG). Because glutathione reductase activity (GRd) did not change, this GSSG could not be reduced, the GSSG/GSH ratio increased by 46%, indicating heightened intracellular oxidative stress. Catalase (CAT) activity also remained unchanged (reduced by 9%, non-significant). Conclusions: These findings highlight the role of oxidative stress in MCS pathophysiology, particularly the disruption of the glutathione cycle within erythrocytes. The study underscores the need for further research into the molecular mechanisms underlying MCS to improve diagnostic criteria and therapeutic strategies. Understanding intracellular oxidative imbalances may provide insights into the systemic dysfunction observed in MCS patients. Full article

The search for natural alternatives to sodium nitrite in meat products is driven by concerns about consumer health and the need to maintain product quality and safety. In this study, the effect of sodium nitrite reduction on the quality parameters of canned pork meat with 1% lyophilized cell-free supernatant (CFS) from L. paracasei B1, during 30 days of storage, was assessed. Reduction of sodium nitrite content led to measurable changes in the color, texture, and oxidative stability of canned pork; however, the presence of 1% CFS helped preserve color, alleviated the negative impact on textural parameters, and limited lipid oxidation, thereby counteracting the typical consequences of nitrite reduction. Among the tested variants, S_75, containing 75% of the standard nitrite dose, showed the best overall balance between color retention, textural integrity, and oxidative stability. Samples without nitrite (S_0) exhibited a noticeable increase in lightness (L*) and decrease in redness (a*) over time, accompanied by a shift towards yellow-brown hues (b*, C*, H°). Importantly, the total color difference (ΔE) was least pronounced in the S_75 variant, with values of approximately 2.5 after 1 day and 2.7 after 30 days, which was markedly lower than in S_50 (ΔE ≈ 6.0 and 3.9) and S_0 (ΔE ≈ 7.9 and 8.5), thereby confirming superior color retention and overall stability during storage. Texture analysis showed that initial hardness and chewiness were higher in nitrite-free samples (S_0), suggesting that the complete omission of nitrite may negatively affect product structure. Nevertheless, all variants softened during storage, and samples with higher nitrite content, particularly S_75, retained better elasticity and cohesiveness. Lipid oxidation, expressed as TBARS values, progressed fastest in samples completely depleted of nitrite (S_0), increasing from 0.31 mg MDA/kg (day 1) to 1.35 mg MDA/kg (day 30), which confirms the antioxidant role of sodium nitrite. Interestingly, the presence of 1% CFS in the variants with reduced nitrite content partially mitigated this effect, as TBARS values in S_75 increased only from 0.29 to 0.46 mg MDA/kg, and, in S_50, from 0.45 to 0.66 mg MDA/kg, compared to the nitrite-free variant. This suggests that CFS may also have contributed to antioxidant protection. Fatty acid profiles remained relatively consistent across methods. Microbiological analysis revealed no significant differences between groups. These results demonstrate that partial nitrite reduction combined with CFS is effective, highlighting the potential of CFS as a promising functional additive in clean label meat preservation. Furthermore, reducing the sodium nitrite content in canned pork products may contribute to improved consumer health by reducing exposure to potentially harmful nitrosamine precursors. Full article

Once a protein of relative obscurity, inositol polyphosphate multikinase (IPMK) emerged as a versatile and indispensable enzyme in cellular biology. With dual inositol and lipid kinase activities, IPMK generates pivotal signaling molecules such as InsP4 (inositol tetraphosphate), InsP5 (inositol pentaphosphate), and PIP3 (phosphoinositide 3,4,5-trisphosphate), positioning it as a critical regulator of cellular mechanisms. Initially identified in yeast and later recognized as essential for mammalian embryonic development, IPMK has transitioned from a niche interest to a focal point in studies of nutrient sensing, growth factor signaling, mRNA transport, and transcription regulation. Over two decades, multidisciplinary research has unveiled its far-reaching biological roles and implications in diverse diseases, including neurodegeneration, cancer, and inflammation. This review charts IPMK’s journey from obscurity to prominence, examining its structure–function relationships, cellular roles, and emerging physiological impacts, while highlighting its potential as a therapeutic target in human health and disease. Full article

The human gut microbiota is a complex ecosystem that influences host metabolism, immune function, and cardiovascular health. Dysbiosis, defined as an imbalance in microbial composition or function, has been linked to the development and progression of atherosclerosis. This connection is mediated by microbial metabolites that enter the systemic circulation and interact with vascular and immune pathways. Among these, trimethylamine N-oxide (TMAO) has been most extensively studied and is consistently associated with cardiovascular events. Other metabolites, including lipopolysaccharides (LPS), short-chain fatty acids (SCFAs), and secondary bile acids, also contribute by modulating inflammation, endothelial function, and lipid metabolism. Recent research has expanded to emerging metabolites such as indoxyl sulfate, indole-3-propionic acid, and polyamines, which may provide additional mechanistic insights. These microbial products are increasingly explored as biomarkers of cardiovascular risk. TMAO has shown predictive value in large human cohorts, while microbiota composition and diversity measures remain less consistent across studies. However, interpretation of these biomarkers is limited by methodological variability, interindividual differences, and lack of standardization. Therapeutic interventions targeting the gut–heart axis are under investigation. Dietary strategies such as the Mediterranean diet and fiber-rich nutrition, probiotics and prebiotics, and fecal microbiota transplantation (FMT) show promise, while pharmacological approaches targeting TMAO or bile acid pathways are in early stages. This review summarizes current knowledge on the mechanistic, diagnostic, and therapeutic links between the gut microbiota and atherosclerosis, highlighting both established findings and emerging directions for future research. Full article

Background/Objectives: The prevalence of obesity continues to rise globally, and with this an increase in the use of herbal weight loss supplements (WLS). At present, there is limited evidence to support the efficacy and safety of WLS, and there have been growing reports of adverse events associated with their use. We aimed to determine those WLS that caused toxicity in vitro and to use ¹H nuclear magnetic spectroscopy (NMR) to examine the metabolomic changes induced by these WLS in human hepatic and intestinal cells. Materials and Methods: This study used in vitro methods and ¹H NMR spectroscopy to analyse the metabolomic changes in vitro of WLS available for purchase in Australia. Ten WLS were selected, nine WLS caused significant toxicity in HepG2 human liver cells, and of these, six met the criteria for ¹H NMR analysis, which was based on a 25–50% reduction in cell viability. Results: All 10 WLS caused a significant reduction in viability of Caco-2 human intestinal cells, with seven selected for metabolic profiling. Orthogonal partial least squares discriminant analysis (O-PLS-DA) of ¹H NMR spectral data was used to characterise the metabolites that differed between the untreated and treated cells and the fold changes of the metabolites were determined. The results showed alterations to key metabolites such as amino acids, glucose, carboxylic acids, and amines in all treatment groups compared to untreated controls across both cell lines. Conclusions: Collectively, these biochemical changes represent disturbances to intracellular proteins, energy metabolism, and membrane lipids suggestive of oxidative stress. This study highlights the need for further investigations into the actions of these WLS in vivo, and, as these products were regulated by the Therapeutic Goods Administration (TGA) at the time of purchase, this study suggests improved pre-market screening to ensure consumer health is protected. Full article

Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values >0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application. Full article

Background. Type 2 diabetes mellitus (T2D) and moderate-to-severe obstructive sleep apnea (OSA) commonly coexist and exacerbate poor glycemic control, systemic inflammation, and diminished quality of life (QoL). Although continuous positive airway pressure (CPAP) therapy has demonstrated metabolic and anti-inflammatory benefits, its real-world impact in Bulgarian outpatient settings—where CPAP costs are borne entirely by patients—has not been characterized. Objectives. To evaluate the effects of six months of CPAP therapy on glycemic control (hemoglobin A₁c [HbA₁c]), systemic inflammation (high-sensitivity C-reactive protein [hsCRP]), body mass index (BMI), lipid profile (low-density lipoprotein [LDL]), QoL (Short Form 36 Physical Component Summary [SF-36 PCS] and Mental Component Summary [SF-36 MCS]), and survival among Bulgarian outpatients with T2D and moderate-to-severe OSA. Methods. In this prospective, multicenter cohort study conducted from January 2022 to July 2023, 142 adults with established T2D and OSA (apnea–hypopnea index [AHI] ≥ 15) were enrolled at three outpatient centers in Bulgaria. Fifty-five patients elected to purchase and use home-based CPAP (intervention group), while 87 declined CPAP—either because of cost or personal preference—and continued standard medical care without CPAP (control group). All participants underwent thorough outpatient evaluations at baseline (month 0) and at six months, including measurement of HbA₁c, hsCRP, BMI, fasting lipid profile (LDL), and patient-reported QoL, via the SF-36 Health Survey. Survival was tracked throughout follow-up. Results. After six months, the CPAP group experienced a significant reduction in HbA₁c from a median of 8.2% (IQR 7.5–9.5%) to 7.7% (6.7–8.7%), p < 0.001, whereas the control group’s HbA₁c decreased modestly from a median of 8.6% (IQR 7.9–9.4%) to 8.3% (7.6–9.1%); p < 0.001), with a significant between-group difference at follow-up (p = 0.005). High-sensitivity CRP in the CPAP arm fell from a median of 2.34 mg/L (IQR 1.81–3.41) to 1.45 mg/L (IQR 1.25–2.20), p < 0.001, while remaining unchanged in controls (p = 0.847). BMI in the CPAP group declined significantly from 28.6 kg/m², IQR 26.6–30.6 to 28 kg/m², IQR 25.6–29.2 (p < 0.001), compared to no significant change in controls (median 28.9 kg/m²), p = 0.599. LDL decreased in the CPAP group from a median of 3.60 mmol/L (IQR 3.03–3.89) to 3.22 mmol/L (IQR 2.68–3.48), p < 0.001, with no significant reduction in controls (p = 0.843). Within the CPAP arm, both SF-36 PCS and SF-36 MCS scores improved significantly from baseline (p < 0.001 for each), although between-group differences at six months did not reach statistical significance (PCS: 48 ± 10 vs. 46 ± 9, p = 0.098; MCS: 46, IQR 40–54 vs. 46, IQR 39–53, p = 0.291). All-cause mortality during follow-up included 2 events in the CPAP group and 11 events in the control group (log-rank p = 0.071). Conclusions. In Bulgarian outpatients with T2D and moderate-to-severe OSA, six months of CPAP therapy significantly improved glycemic control, reduced systemic inflammation, lowered BMI and LDL, and enhanced QoL, with a non-significant trend toward reduced mortality. These findings underscore the importance of integrating CPAP into multidisciplinary management despite financial barriers. Full article

Postmenopausal osteoporosis (PMOP) has become an important public health issue. The diagnosis of PMOP relies on clinical symptoms and radiology. However, most patients with PMOP do not exhibit obvious symptoms in the early stages of this disease. This study aimed to explore the feasibility of surface-enhanced Raman scattering (SERS) technology in the auxiliary screening of PMOP. PMOP rats were induced by ovariectomy (OVX) surgery, with a Sham group and an icariin (ICA) treatment group serving as controls. A monolayer film of Au nanoparticles (NPs) was prepared using the Marangoni effect in an oil/water/oil three-phase system, and was used to detect serum SERS signals in the Sham, OVX, and ICA treatment groups. Then, the spectral diagnostic model for PMOP screening was established utilizing partial least squares (PLS) and support vector machine (SVM) algorithms. Histopathology confirmed the establishment of the PMOP rat model. The assignment of Raman peaks and the analysis of spectral differences revealed the biochemical changes associated with PMOP, including the upregulation of tyrosine levels and the downregulation of arginine, tryptophan, lipids, and collagen. When employing the PLS-SVM algorithm to simultaneously classify and discriminate three groups of samples, the diagnostic sensitivity for PMOP is 93.33%, the specificity is 96.67%, and the accuracy of three-class classification is 91.11%. This study demonstrated the potential of SERS for the auxiliary screening of PMOP. Full article

Non-alcoholic fatty liver disease (NAFLD) has emerged as a significant metabolic disorder in modern poultry production, particularly affecting high-yielding laying hens. This condition compromises bird welfare, productivity, and economic sustainability within commercial farming systems. This narrative review provides a comprehensive overview of the underlying mechanisms through which hepatic lipid accumulation, metabolic dysfunctions, hormonal imbalances, genetic susceptibilities, and environmental stress contribute to the development of NAFLD. The multifactorial nature of NAFLD is explored through a critical assessment of the literature, highlighting the influence of diet composition, management practices, and physiological demands associated with intensive egg production. Emphasis is placed on recent advancements in nutritional modulation, selective breeding, and housing improvements aimed at prevention and mitigation of NAFLD. Furthermore, the review identifies key research gaps, including limited understanding of epigenetic influences and the long-term efficacy of intervention strategies. An integrative framework is advocated, synergizing genetics, nutrition, and environmental optimization to effectively address the complexity of NAFLD in poultry and supports the development of resilient production systems. The insights presented aims to inform both future research and practical applications for enhancing poultry health and performance. Full article

Microalgae are unicellular photosynthetic organisms with considerable genetic diversity and remarkable metabolic capacity, positioning them as sustainable cellular biorefineries. They can be cultivated in open or closed systems, influenced by physical and chemical variables such as light, temperature, and nutrient availability. These conditions modulate the synthesis of valuable biomolecules, including proteins, lipids, polysaccharides, and secondary metabolites. Microalgae are especially notable for their high protein content (up to 70% w/w in Spirulina sp.), polyunsaturated fatty acids (e.g., DHA and EPA), and β-glucans with bioactive properties. Choosing the correct extraction method (mechanical, enzymatic or combined) is very important to obtain and preserve the functionality of these compounds. Despite their biotechnological potential in functional foods, pharmaceuticals, and biofuels, industrial development faces challenges such as extraction efficiency, scalability, and regulatory approval. This review compiles current knowledge on the nutritional and bioactive potential of microalgae, highlights advances in extraction technologies and discusses their potential applications in health-oriented industrial innovation. Full article

Background: There is a worldwide increase in the prevalence of type 2 diabetes, and strategies for managing this condition include dietary interventions. These interventions include the use of a low-glycaemic index diet, high-fibre and prebiotic diets, and low-carbohydrate diets (LCDs), which improve glycaemic control, reduce the risk of diabetic complications, and promote health. However, the definition of LCDs varies across the literature, and the use of LCDs in managing people with diabetes is often seen as controversial. Therefore, the aim of this review is to examine current advances and future prospects in the use of LCDs in managing people with type 2 diabetes. Method: A systematic review of randomised controlled trials, which applied both the PRISMA and PICOS frameworks. Databases including MEDLINE, APA PsycInfo, Academic Search Premier, CINAHL Plus with Full Text, APA PsycArticles, and Psychology and Behavioural Sciences Collection were searched through EBSCOHost. The EMBASE database and reference list of articles were also searched for articles of interest. Two researchers conducted the searches independently from database inception to 28 August 2025. However, based on the inclusion criteria, the year of publication of studies was restricted to articles published from 2021. The search terms were combined using Boolean operators (AND/OR), and duplicates were removed in EndNote. The articles were screened for eligibility based on inclusion and exclusion criteria by two researchers. Results: The findings identified that an LCD is significantly (p < 0.05) more effective in reducing glycaemic parameters compared to a usual diet, standard care, or a control diet in people with type 2 diabetes. Similarly, the effect of LCD was significant (p < 0.05) in reducing BMI in patients with type 2 diabetes compared with the control diet. However, an LCD did not appear to have a significant (p > 0.05) effect on lipid parameters compared to a control diet. Conclusion: This systematic review found that LCDs are significantly (p < 0.05) more effective in promoting glycaemic control than a usual diet, standard care, or a control diet in people with type 2 diabetes. In addition, LCDs can be an effective strategy for reducing BMI in individuals with type 2 diabetes, particularly when implemented as part of a structured, sustained dietary intervention. However, there was variability in the findings of the studies included with respect to glycaemic control and BMI. Furthermore, the impact of LCD on glycaemic control did not appear sustainable in the long term. LCDs did not have a significant (p > 0.05) effect on lipid parameters compared to a control diet. Full article

Background/Objectives: Atherosclerosis is a major contributor to ischemic cardiovascular diseases (CVDs) such as myocardial infarction and stroke, which are leading causes of mortality and morbidity. The management of atherosclerosis through personalized nutrition has gained importance in recent years due to advancements in nutrigenomics, gut microbiome evaluation, and metabolomics. However, no systematic review has comprehensively evaluated the impact of personalized nutrition interventions on atherosclerotic plaque progression and clinical outcomes in humans. Methods: We adopted a systematic approach based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Key databases like PubMed, Cochrane, Google Scholar, and MEDLINE via EBSCOhost were searched using predefined terms related to personalized nutrition, atherosclerosis, nutrigenomics, and clinical outcomes. Results: Evidence evaluation using the framework of Boffetta et al. for cumulative evidence on the joint effects of genes and environments strongly suggested significant diet–gene interactions. Polymorphisms in the apolipoprotein A-II (APOA2) gene have been shown to influence body mass index and lipid levels. Furthermore, studies have demonstrated that omega-3 polyunsaturated fatty acids (PUFAs) can modulate microRNA expression, thereby impacting lipid metabolism. Epigenetic studies showed that dietary components can modify histone acetylation and non-coding RNA activity, which ultimately influence gene expression related to inflammation and lipid metabolism, improving clinical outcomes in atherosclerosis management. Conclusions: Integrating personalized nutrition into clinical practice promises to enhance atherosclerosis outcomes through targeted dietary interventions. Advancements in personalized nutrition offer a promising pathway toward more effective and personalized approaches to cardiovascular health. Full article

The aim of the study was to compare the quality of almond oils obtained using different extraction methods, including cold solvent extraction, Soxhlet extraction, and the Folch method. Oils were extracted from four commercially available almond-based products—unpeeled almonds, blanched almonds, almond flakes, and almond protein concentrate—and compared with a commercially refined almond oil. The extracted oils were analyzed for their fatty acid (FA) composition and selected quality parameters, including acid value, peroxide value, p-anisidine value, the TOTOX index, and specific extinction coefficients (K₂₃₂ and K₂₆₈). Based on the FA profiles, health-related indices such as atherogenic index, thrombogenic index, and hypocholesterolemic/hypercholesterolemic ratio were also calculated. Additionally, the oxidative stability of the oils was assessed using an accelerated method—pressure differential scanning calorimetry. The obtained results demonstrated that the extraction method had a stronger influence on almond oil quality than the type of raw material. Oil extracted from unpeeled almonds using Soxhlet and cold solvent techniques showed better oxidative stability and more favorable FA profiles, while oils obtained using the Folch method and commercial refined oils exhibited higher levels of primary and secondary oxidation products. These findings were further supported by statistical analyses, which revealed distinct groupings based on oxidation indices and lipid composition. Full article

Background/Objectives: While the benefits of almond consumption in reducing levels of TC and LDL-C are well established, the effects on additional lipids that have emerged as important predictors of cardiovascular disease, such as ApoB and the ratio of ApoB:ApoA, are not well characterized. In this systematic review and meta-analysis, the effects of almond consumption on blood lipids were comprehensively assessed. Methods: On 12 May 2025, ProQuest Dialog™ was used to search ten literature databases (AdisInsight: Trials; Allied & Complementary Medicine™; BIOSIS Previews^®; CAB ABSTRACTS; Embase^®; Embase Preprints; Foodline^®: SCIENCE; FSTA^®; MEDLINE^®; National Technical Information Service). Randomized controlled trials at least 4 weeks in duration were included if the investigational product was almonds; the control was void of nuts/tree nuts; the subjects were adults without CVD; and blood lipid levels were assessed. Health Canada’s Quality Appraisal Tool for Intervention Studies was used to assess each study’s risk of bias. The mean difference in the effect for each parameter was pooled across studies in a random effects model, using the inverse of the variance as the weighting factor. Results: 36 publications (48 almond–control datasets) representing 2485 participants were included. Almond consumption significantly reduced LDL-C (−0.132 mmol/L; 95% CI: −0.190, −0.075 mmol/L; p < 0.001), TC (−0.160 mmol/L; 95% CI: −0.218, −0.101 mmol/L; p < 0.001), non-HDL-C (−0.204 mmol/L; 95% CI: −0.281, −0.127 mmol/L; p < 0.001), TC:HDL-C (−0.154; 95% CI: −0.246, −0.063; p = 0.001), LDL-C:HDL-C (−0.112; 95% CI: −0.199, −0.026; p = 0.011), ApoB (−4.552 mg/dL; 95% CI: −6.460, −2.645 mg/dL; p < 0.001), and ApoB:ApoA (−0.027; 95% CI: −0.046, −0.008; p = 0.006), with a borderline significant reduction in TG (−0.037 mmol/L; 95% CI: −0.079, 0.005; p = 0.085) and no effects on HDL-C, ApoA, or Lp[a]. The effects persisted when the analyses were limited to higher quality studies, except for the reduction in TG. Conclusions: Almond consumption improves levels of LDL-C, TC, non-HDL-C, TC:HDL-C, LDL-C:HDL-C, ApoB, and ApoB:ApoA, though dedicated clinical trials are needed to better understand effects on TG levels. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a significant global public health issue, affecting approximately 25% of the population and currently offering limited treatment options. Trimetazidine (TMZ) serves as a metabolic modulator that shifts cellular energy metabolism from fatty acid oxidation to glucose oxidation, thereby providing a novel therapeutic strategy aimed at addressing the underlying metabolic dysfunctions that contribute to the pathogenesis of MASLD. Our study aims to assess the efficacy of trimetazidine in improving hepatic steatosis, inflammation, and various metabolic parameters. Methods: In this double-masked, randomized controlled trial, 60 patients with confirmed MASLD diagnoses were randomly assigned in a 1:1 ratio to receive either trimetazidine 20 mg three times daily or a placebo, alongside lifestyle modifications, for 24 weeks. The trial was conducted in accordance with the Declaration of Helsinki and approved by the ethics committees of both participating institutions. We measured changes in hepatic steatosis, non-invasive fibrosis scores, inflammatory markers (including interleukin-6, tumor necrosis factor-alpha, and highly sensitive C-reactive protein), liver enzymes, and lipid profiles at baseline and at the end of the 24 weeks. Results: Hepatic steatosis decreased significantly, with controlled attenuation parameter scores from 352.5 to 302 dB/m in the TMZ group compared to the control (p < 0.001). TNF-α was reduced significantly in the TMZ group compared to the control group (p = 0.001). Fibrosis to AST score decreased from 0.49 to 0.25 in the TMZ group (p < 0.001). Aspartate aminotransferase decreased significantly compared to the control group (p 0.032). Notably, TMZ also imparted cardioprotective benefits, reducing total cholesterol by 14%, LDL by 17% (both p < 0.05), and triglycerides by 16% (p = 0.176). Conclusions: This groundbreaking trial supports the potential of trimetazidine as a promising therapeutic agent for MASLD, indicating substantial improvements in hepatic steatosis, inflammation, and metabolic disturbances. These findings underscore the urgency and importance of further multicenter trials to validate trimetazidine’s efficacy as a disease-modifying therapy for MASLD. Full article