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Inflammation-associated anorexia, prevalent gastrointestinal symptoms due to slow intestinal transit, disrupted appetite regulation, and energy expenditurelinked to overexpression of leptin, increased bound leptin, irregular ghrelin secretion, and blunted ghrelin responsescorrelate with liver disease severity and systemic inflammation, further reducing food intake quantity and frequency of spontaneous food consumption (12, 16)

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Clinicians must confirm the current rules, and where to verify them, before considering DSIP in any setting, because peptide regulation continues to change