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doi: 10.1111/dom.14940

(2019) recently showed that the oral betaine treatment not only restored the methionine-Hcy cycle, but also reduced hepatosteatosis, oxidative stress ( via increasing glutathione levels and antioxidant enzyme activities), inflammation ( via induction of anti-inflammatory IL-10 and decreasing proinflammatory TNF and IL-6 expression), and apoptosis ( via reduction of proapoptotic mediator Bax and induction of anti-apoptotic mediator Bcl-2), but also found to activate autophagy ( via increase the expression of beclin 1, Atg4 and Atg5, the autophagy activators) and prosurvival Akt/mTOR signaling in the liver of methionine and choline deficient diet (MCD)-induced NAFLD mice

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Melanotic macules are observed on the mouth, genitalia and the nails