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Moreover, it interacts with nuclear receptors and transcription factors to activate the transcription of lipid metabolic genes, and its activity is responsive to aerobic metabolic events [9,10]

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8.4 Adjunctive application of probiotics and synbiotics 8.4.1 Evidence hierarchy in probiotic/synbiotic interventions for DKD The therapeutic potential of probiotics and synbiotics in DKD management is supported by a hierarchical body of evidence spanning mechanistic studies to clinical trials