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Similarly, BCAA elevation in DKD reflects both impaired renal catabolism (reduced mitochondrial BCKDH activity) and insulin resistance-driven alterations (133), with standard eGFR adjustment being insufficient as GFR lies on the causal pathway between metabolites and outcomes

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sCT when bound to AMYRs induce a CT-like receptor conformation 15 , while P32Y substitutions of CT analogues are also detrimental to affinity and potency at AMYRs 18,19

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