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However, an elevated A1c result provides objective evidence that metabolic dysfunction has already begun

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Disruption of lipid mobilization pathways via HSL inhibition, PLIN dysregulation or excessive lipid accumulation impairs estrogen and progesterone synthesis, follicular rupture and corpus luteum formation (150)

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Funding Grant/financial support: The work was supported by the NIH Center Grant P30, EY014801, NINDS 1R01NS111115-01 (Wang), and a grant from Research to Prevent Blindness (RPB)