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However, clinical outcomes are complicated by behavioral factors, including lower adherence rates reported among women, which may obscure the true extent of sex-related efficacy differences [52]

1 H MRS in the muscle allows detection of multiple metabolites, of which creatine, acetyl-carnitine, carnosine and intramyocellular lipids (IMCL) have been shown to be useful biomarkers of muscle metabolism [23]

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