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Collectively, these extra-hepatic effects create a favorable systemic metabolic environment that indirectly but substantially benefits hepatic steatosis and MASH

Magnesium must be present in the digestive tract at the same time as oxalate-containing foods in order to bind dietary oxalate and prevent it from being absorbed into general circulation, where the oxalate then has to be filtered by the kidneys, and is excreted into the urine

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In contrast, perioperative immune paralysis often arises within days, tracks with systemic inflammation and metabolic stress, and may be partially reversible as homeostasis is restored, resembling the transient immunosuppressive state described in sepsis rather than chronic antigen exposure ( A key unresolved question is whether perioperative immune dysfunction engages the core transcriptional circuitry of exhaustion