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At baseline, plasma carnitine concentration was about 10% lower in vegetarian compared to omnivorous participants

Over time, irregular collagen organization and aberrant cross-linking increase tissue stiffness and perpetuate fibroblast activation through mechanical feedback mechanisms, contributing to progressive joint impairment (140, 141)

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DES(1-3) IGF-1 is a truncated variant missing the first three N-terminal amino acids (Gly-Pro-Glu), which also reduces IGFBP binding but through a different structural mechanism removal of the N-terminal tripeptide rather than charge substitution