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This leads to peripheral and hepatic insulin resistance and compensatory intra-portal hyperinsulinemia, which results in increased hepatic GH sensitivity that aggravates the condition further ( Table 1

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NMDA receptors are an exemplar of this dynamic at work, where the balance between primarily inhibitory effects of NO-mediated NMDA receptor nitration and the bimodal and highly concentration-dependent effects of extracellular polyamines at NMDA receptors put interactive guardrails around the range of permitted NMDA calcium flux (Figure 2