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In NAFLD, gut flora dysbiosis often leads to reduced BSH activity, manifested as the accumulation of conjugated bile acids (such as taurocholic acid and taurochenodeoxycholic acid) in feces and serum, while unconjugated and secondary bile acids (such as deoxycholic acid (DCA) and lithocholic acid) decrease

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They remove metabolic waste, regulate fluid and electrolytes, maintain bicarbonate and acid–base balance, and help clear compounds that can accumulate when detoxification pathways are under strain