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Deficiency reduces insulin sensitivity and increases the risk of atherosclerosis, CVD, T2DM, and hypertension [168,169,170]

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This protective effect primarily resulted from enhanced carbohydrate response element binding protein (ChREBP)-mediated de novo lipogenesis via AKT signaling activation, along with increased PPAR-dependent fatty acid -oxidation (117)

A laboratory instrument may or may not detect those mutations, which can present a challenge to clinical interpretation