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A second mechanism of PKA-independent incretin potentiation of glucose-stimulated insulin secretion (GSIS) involves cAMP-regulated guanine nucleotide exchange factor (cAMP-GEF) EPAC2

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Consequently, the symbiotic relationship between oocytes and granulosa cells, governed by metabolic and signaling interactions, renders the follicle highly susceptible to mitochondrial dysfunction, which can precipitate a cascade of pathological alterations, including impaired follicular development, abnormal hormone synthesis, and reduced oocyte quality

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