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In another study treatment with 20nM Ex-4 on rat adipose-derived MSC additionally elevated OPG and RUNX2 protein levels, while reducing osteoclast activity [29]

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2014;5(5):e1209

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However, the exact mechanism by which IGF-1 improves insulin signalling has not yet be explained (other than indirect actions through lipid clearance from the bloodstream by inhibiting GH (lipolysis on adipocytes) and FFA uptake by muscles