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When metabolic stress occurs, MOTS-c in cells can be transferred to the nucleus in an AMPK-dependent manner and bind to transcription factors regulated by ARE, thus improving the stress resistance of cells (16, 24)

Although trends toward greater symptomatic and MRI improvement were observed in younger patients and those with lower BMI, these analyses were exploratory and underpowered, particularly in the BMI 28 kg/m 2 subgroup