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J Anaesthesiol Clin Pharmacol 34(3):411-413, 2018

Defects in transsulfuration pathway, such as CBS deficiency, promote elevated Hcy, SAH and SAMe thereby destabilizing SAMe homeostasis, with diminished SAMe/SAH ratio, reduced GSH and lower PEMT activity which can promote the setting of mild steatotic liver disease (SLD) [52,53,54,55,56]