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Anti-apoptosis and autophagy are among the main ways to maintain the malignant proliferation of MDR cells, so the therapeutic effect of phenformin in MDR cancer is worthy of further exploration

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It is also involved in immune function, metabolism, tissue building and repair, sperm cell formation, and certain enzyme functions

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Impaired insulin signaling, diminished mitochondrial oxidative capacity, lipid peroxidation, ferroptosis, and microbial dysbiosis not only exacerbate hepatic steatosis but also facilitate the progression from simple steatosis to more severe forms of the disease, such as NASH and cirrhosis [51,56,63,64,65,66,67]