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As insulin sensitivity improves, SHBG rises, and the amount of biologically active testosterone drops, even beyond what the reduction in total testosterone production would predict

The clinical implications are especially interesting because, although GLP-1 receptor agonists have been shown to benefit patients, they often do not produce sufficient metabolic improvement to achieve diabetes remission or to prevent major cardiovascular events among high-risk patients

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TABLE 1 Effect of physical activity on neurogenesis and cognitive function after stroke

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