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However, this theory inadequately explains the intricate metabolic and pathological processes of MAFLD, leading to the emergence of the "multiple-hit theory." This model attributes MAFLD progression to numerous parallel factors, including dysregulated adipokines, cytokines, mitochondrial dysfunction, endoplasmic reticulum stress, gut microbiota alterations, lipid metabolism, lipotoxicity, oxidative stress, genetic susceptibility, and epigenetic changes [5]

66 Furthermore, the complex formed by uric acid and free iron ions acts as a chelating agent, effectively inhibiting the formation of free radicals from iron ions and enhancing the antioxidant effect

Endocrinology 153 , 30543065 (2012)