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When cirrhosis develops, a state of hepatic GH resistance ensues resulting in high GH and low IGF-I levels (125) ( Figure 1E )

Chen JF, Cunha RA

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In addition, metabolic flux analysis using D-glucose- 13 C 6 demonstrated an increase of pyruvate and a reduction in malate and citrate levels, suggesting a decreased flux toward the tricarboxylic acid cycle after bTNF- stimulation

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