SIRT3 and metabolic dysfunction-associated steatotic liver disease: Xu et al. review pharmacological and clinical data demonstrating that BBR improves insulin resistance, hyperlipidemia and NAFLD (Non-Alcoholic Fatty Liver Disease) by a combination of AMPK (AMP-activated protein kinase) activation, suppression of key gluconeogenic enzymes (PEPCK or Phosphoenolpyruvate carboxykinase, G6Pase or Glucose-6-phosphatase), enhancement of glycolysis, and stimulation of SIRT3 (Sirtuin 3)-dependent β-oxidation, while simultaneously correcting gut dysbiosis and intestinal barrier dysfunction [21].