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Research has also demonstrated that metformin increases the abundance of Akkermansia muciniphila in the gut, which triggers the transcription of host antioxidant genes, including Nqo1 , Ho-1 , and Gpx4 [17]

While these processes are essential for maintaining hormonal balance, elevated enzyme activity can lead to excessive estrogen reabsorption and contribute to hormone-related diseases

doi:10.1152/ajplung.1989.257.4.L163

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