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A meta-analysis, which was limited by the low number and heterogeneity of the studies considered (in terms of selection criteria, baseline iron stores, outcomes and duration of observation), concluded that in patients with nonalcoholic fatty liver disease (NAFLD) with or without DIOS, iron depletion had only a minor effect on the improvement of alanine aminotransferase levels, but did not affect insulin resistance and liver histology compared with lifestyle changes alone 86

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