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In contrast, no benefits on the rate of decline in glomerular filtration rate have been seen in trials of DPP-4 inhibitors, perhaps because the renal actions of DPP-4 inhibitors are primarily mediated by potentiation of SDF-1, not GLP-1

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Mechanistic hypotheses include reduced leptin-driven T-helper (Th)1/Th17 activity, improved adipokine balance, and modulation of gut-thyroid axis pathways

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