Dietary Glycine Supplementation in Metabolic Dysfunction-associated Steatotic Liver Disease

Exclusion Criteria

• •1. Uncontrolled diabetes (HbA1c \> 8%)
• •2. Type 1 Diabetes Mellitus
• •3. Clinically significant anemia (Haemoglobin \< 10 g/dL)
• •4. Chronic liver disorders (except MASLD) such as Hepatitis B, Hepatitis C, Wilson's disease, hemochromatosis, autoimmune hepatitis, chronic cholestatic disorders, and liver cirrhosis
• •5. Drugs that may induce hepatic steatosis, such as methotrexate, amiodarone, tamoxifen, or Systemic steroid usage (eg. prednisolone, hydrocortisone, cortisone, dexamethasone)
• •6. Glomerular filtration rate (GFR \< 30 ml/min)
• •7. Serum alanine transaminase (ALT) \> 3x upper limit of normal (ULN)
• •8. Serum aspartate transaminase (AST) \> 3x ULN
• •9. Liver cirrhosis
• •10. Significant alcohol consumption (\> 20g/day for women and \>30g/day for men)
• •11. Receiving weight loss medications or GLP-1 receptor agonists
• •12. Pregnancy
• •13. Uncontrolled thyroid disease
• •14. Previous bariatric surgery
• •15. Weight loss \> 5% in the past 1 month
• •16. Metallic implants (including incompatible pacemakers, AICD, metallic heart valves) or other contraindications to MRI
• •17. Claustrophobia
• •18. Any factors likely to limit adherence to study protocol (e.g., dementia; alcohol or substance abuse; history of unreliability in medication taking or appointment keeping; significant concerns about participation in the study from spouse, significant other, or family members)