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Elevated GGT often appears alongside pre-diabetes and metabolic syndrome, even before a formal diabetes diagnosis

These mechanisms have been demonstrated primarily in laboratory and animal studies

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NFAT5 (TonEBP), as a key osmosensing transcription factor, participates in differentiation regulation by modulating Sox9 ( In summary, the IVD hyperosmotic environment typically inhibits cell growth and anabolism, but a moderate increase in osmotic pressure may induce chondrogenic/NP-like differentiation