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This increase in lipids and intramyocellular lipid metabolites, a major inhibitor of insulin signaling and glucose transport, causes insulin resistance in muscle

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10.1016/S0140-6736(17)32284-5 26

VKORC1 and CYP2C9 polymorphisms and daily dose requirements Carriers of alleles coding for reduced CYP2C9 and/or VKORC1 enzyme activity require lower warfarin doses and have been observed to be more difficult to titrate to a stable maintenance dose than those needing higher doses

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