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Second, improvements in IR and glycaemic indices are most apparent in higher-burden phenotypes, particularly in women with impaired glucose tolerance/prediabetes or related metabolic comorbidities, where changes in HOMA-IR, fasting glucose and OGTT profiles are more pronounced and may plausibly reduce periconception metabolic risk

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A.StadtmanE

Notably, certain metabolites may exhibit context-dependent functional polarity, where even the same metabolite can produce opposing effects depending on experimental conditions, dosage regimens, or disease stages