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Moreover, the presence of diminished muscle mass and power, aberrant muscle quality characterized by increased fat or myosteatosis, electrolyte imbalances, malnutrition, subclinical myopathy, diminished motivation, memory, and concentration, alongside an array of mental health and sleep disorders directly linked to or associated with the underlying disease, further exacerbate, and contribute to fatigue in cirrhosis (9)

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654 The most widely accepted mechanisms underlying the pathogenesis of NAFLD include lipid metabolism disorders, mitochondrial dysfunction, oxidative stress, and ER stress