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The most common side effects include nausea, constipation, bloating, and heartburn

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In contrast, increased OS may disrupt the homeostasis and metabolism of the ECM by influencing the levels of MMPs/TIMPs and the activation of the TGF-1/Smad signalling pathway

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The mechanism involves multiple pathways: improved insulin sensitivity reduces hepatic triglyceride production, slower gastric emptying decreases dietary fat absorption, and enhanced glucose control reduces inflammatory markers that drive atherosclerosis