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Thrombin activates the hypoxia-inducible factor-1 signaling pathway in vascular smooth muscle cells: Role of the p22(phox)-containing NADPH oxidase

Although a single RCT failed to observe a statistically significant improvement in HOMA-IR (85), this discrepancy is more likely attributable to limited sample sizes, restricted follow-up windows, and heterogeneity in baseline metabolic phenotypes rather than a lack of efficacy

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Adding GIP activation unlocked additional metabolic pathways that single targeting could not access