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Importantly, insulin forms a hexameric structure by coupling with two zinc ions, a process necessary for the maturation of insulin within the secretory granules of pancreatic -cells and the subsequent release of insulin [62,63] (Figure 4)

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Therefore, the lipids accumulation, infiltration of immune cells, and activation of hepatic stellate cells in hepatocytes can induce ferroptosis, thus promoting MAFLD progression

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