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Mechanistically, AMPK promotes the phosphorylation of sphingomyelin phosphodiesterase 3 (SMPD3), stabilizing the latter and therefore increasing intestinal ceramide formation, which contributes to NAFLD progression to non-alcoholic steatohepatitis (NASH)

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Areca nut chewing and esophageal squamous-cell carcinoma risk in Asians: a meta-analysis of case-control studies

In addition, ingestion can lead to absorption of the various alcohols which may cause lethargy and metabolic acidosis in severe cases

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