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In addition, we found that TG levels in HepG2 cells were not reduced by NaB intervention alone but were markedly reduced by the combination of NaB with GLP-1, suggesting that NaB alleviated hepatic steatosis partially through enhancing GLP-1 action

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To address this, the FDA updated its guidelines in 2016, allowing metformin use in patients with mild to moderate kidney impairment but advising against its use in those with severe kidney disease (eGFR below 30 mL/min/1.73 m)

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