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In hepatocytes with HO-1 overexpression, cell viability was markedly impaired, and this effect was further exacerbated by FAC treatment

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This early pathological change can further activate a series of cascade reactions, including metabolic disorders, hemodynamic abnormalities, ERS, inflammatory responses and fibrotic processes, leading DKD to progress from early functional impairment to irreversible organic lesions (91)

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Systemic primary carnitine deficiency: An overview of clinical manifestations, diagnosis, and management