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Cases 1 to 3 & 8, who had history of upper GI surgery ( Table 1 ), were started on metformin at 500 mg, gradually increased to 2 g daily, based on their response

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Interestingly, Gro3P accumulation caused by loss of solute carrier transporter SLC25A13, which leads to Citrin deficiency, was found to directly activate the transcription factor ChREBP to induce expression of fibroblast growth factor 21 (FGF21), which modulates food and alcohol preferences in the brain and contributes to metabolic dysfunction-associated steatotic liver disease (MASLD)[formerly known as non-alcoholic fatty liver disease (NAFLD)] 19