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Thiamine deficiency reduces the activity of thiamine-dependent enzymes, notably -ketoglutarate dehydrogenase complex, resulting in mitochondrial dysfunction, which leads to reduced activity of the tricarboxylic acid cycle in endothelial cells, astrocytes, and microglia

It is thought that hormonal changes such as this hypocortisolism may result in symptoms of fatigue experienced by patients (255, 428, 429)

The activation of the hepatic A1 adenosine receptor (A1AR) inhibited the maturation of SREBPs by reducing SCAP content and its anchoring in the Golgi apparatus, while prevented the phosphorylation and nuclear translocation of mature SREBPs, particularly SREBP1c and SREBP2 by decreasing adenylate cyclase activity to reduce cAMP levels and lower protein kinase A catalytic subunit (PKAc) activity, eventually, reducing lipid accumulation, and slowing progression of MASLD caused by HFD [10]

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