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Unlike linear pathways, the TCA cycle operates in a cyclic manner, with oxaloacetate serving as both the initial material for citrate synthesis, catalyzed by citrate synthase and the final product, produced by malate dehydrogenase, ensuring continuous renewal of the cycle

Main exclusion criteria included BMI 20 kg/m, type 1 diabetes mellitus, type 2 diabetes mellitus, previous treatment with insulin or with oral hypoglycemic or insulin-sensitizing agents, history of malignancy, and hypopituitarism

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The gut barrier plays a crucial role in preventing the entry of harmful substances into the bloodstream and maintaining immune system balance