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In vitro studies have shown that addition of DPP-4 is associated with impaired insulin signaling in primary human adipocytes, skeletal muscle, and smooth muscle cells (79), while conversely, silencing Dpp4 (using short interfering RNA) resulted in improved adipocyte insulin responsiveness (89)
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The effect of excess thyroxine on osteoblast function is less clear but the imbalance between formation and resorption is evident and is associated with increased expression of RANKL and OPG 38,39 Table 1)
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