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The main hormonal alterations found in PCOS include increased luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio, hyperandrogenism, and insulin resistance, with consequent compensatory hyperinsulinemia, occasionally independent of body weight [2, 8]

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Intracellularly, it is involved in the biosynthesis of nicotinamide and adenine dinucleotide, but it is also released extracellularly, where it appears to have a wide range of effects, including stimulating angiogenesis and endothelial cell proliferation

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