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Among these, inflammation, oxidative str1ss and endoplasmic reticulum stress, alteration of adipokine secretion pattern (particularly reduction in secretion of insulin-sensitizing adipokines such as adiponectin, omentin, and vaspin) and hormones, reduced catabolism of branched-chain amino acids, and release of exosomes carrying microRNAs capable of interfering with insulin signaling [20, 21]

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Common symptoms include abdominal pain, fever, nausea, vomiting, changes in stool (most often constipation but occasionally diarrhea), says Dr