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3
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Pro
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Ob
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9
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T
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[
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h
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s
ed
lev
els
o
f
o
m
en
tin
-
1
ten
d
to
ex
h
ib
it
th
is
c
o
n
d
itio
n
[
1
1
]
.
I
t
is
im
p
o
r
ta
n
t
to
m
ain
tain
in
s
u
lin
r
esis
tan
ce
in
d
iab
etes
m
an
ag
em
en
t
,
wh
ich
ca
n
b
e
ac
h
iev
ed
th
r
o
u
g
h
v
ar
i
o
u
s
ap
p
r
o
ac
h
es
s
u
ch
as
d
ietar
y
in
ter
v
en
tio
n
s
,
p
h
y
s
ical
ac
tiv
ity
,
ph
ar
m
ac
o
t
h
er
ap
y
,
an
d
s
tim
u
l
atio
n
o
f
in
s
u
lin
s
ec
r
etio
n
[
1
2
]
.
No
tab
l
y
,
a
d
v
an
ce
d
ag
e,
b
o
d
y
weig
h
t,
a
n
d
ex
er
cise
ar
e
co
n
s
id
er
ed
s
ig
n
i
f
ican
t
f
ac
to
r
s
in
f
lu
en
cin
g
o
m
en
tin
-
1
le
v
els
in
th
e
b
o
d
y
[
1
1
]
.
I
n
p
ar
tic
u
lar
,
ex
er
cise
-
in
d
u
ce
d
elev
atio
n
o
f
o
m
en
tin
-
1
lev
els
h
as
b
ee
n
s
h
o
wn
to
p
o
s
itiv
ely
im
p
ac
t
g
lu
co
s
e
h
o
m
eo
s
tasi
s
an
d
en
h
an
ce
lip
o
ly
s
is
[
1
3
]
.
Ph
y
s
ical
ac
tiv
ity
is
co
n
s
id
er
e
d
h
ig
h
l
y
ef
f
ec
tiv
e
n
o
n
-
p
h
ar
m
ac
o
lo
g
ical
ap
p
r
o
ac
h
f
o
r
ad
d
r
ess
in
g
in
s
u
lin
r
esis
tan
ce
,
ex
er
tin
g
n
o
tab
le
e
f
f
ec
ts
o
n
v
ar
io
u
s
m
etab
o
lic
a
n
d
p
h
y
s
io
lo
g
ical
p
r
o
ce
s
s
es
[
1
4
]
.
Hig
h
-
in
ten
s
ity
tr
ain
in
g
(
HI
T
)
r
e
p
r
esen
ts
an
ex
er
cise
m
o
d
ality
ch
ar
ac
ter
iz
ed
b
y
in
ten
s
ities
s
u
r
p
ass
in
g
6
5
%
o
f
m
ax
im
u
m
s
p
ee
d
.
T
h
is
f
o
r
m
o
f
e
x
er
cise
h
as
em
er
g
ed
as
a
v
alu
ab
le
alter
n
ativ
e
to
co
n
v
en
tio
n
al
ex
e
r
c
is
e
r
eg
im
en
s
,
wh
ich
ty
p
ically
in
v
o
lv
e
l
o
w
to
m
o
d
er
ate
i
n
ten
s
ities
s
u
s
tain
ed
o
v
er
lo
n
g
er
d
u
r
atio
n
s
.
HI
T
h
as
d
e
m
o
n
s
tr
ated
ef
f
ec
tiv
en
ess
an
d
h
as b
ee
n
p
r
o
p
o
s
ed
as a
n
in
ter
v
en
tio
n
f
o
r
w
ei
g
h
t r
ed
u
ctio
n
[
1
5
]
.
Acc
o
r
d
in
g
to
Am
e
r
ic
an
d
ia
b
e
tes
ass
o
ciatio
n
(
ADA)
[
1
6
]
,
a
b
s
en
ce
o
f
r
eg
u
lar
ex
e
r
cis
e
is
co
n
s
id
er
ed
th
e
f
o
u
r
th
r
is
k
f
ac
to
r
f
o
r
d
ev
elo
p
in
g
co
r
o
n
ar
y
ar
ter
y
/
h
ea
r
t
d
is
ea
s
e.
R
e
s
is
tan
ce
ex
er
cise
i
s
lik
ely
to
im
p
r
o
v
e
g
lu
co
s
e
co
n
tr
o
l,
in
s
u
lin
r
esis
tan
ce
,
lip
id
m
ass
,
a
n
d
b
lo
o
d
p
r
e
s
s
u
r
e
[
1
7
]
.
N
o
tab
ly
,
a
s
tu
d
y
r
e
p
o
r
ted
an
in
cr
ea
s
e
i
n
o
m
e
n
t
i
n
-
1
c
o
n
c
e
n
t
r
a
t
i
o
n
s
i
n
t
h
e
b
l
o
o
d
o
f
o
b
e
s
e
c
h
i
l
d
r
e
n
f
o
l
l
o
w
i
n
g
a
1
6
-
w
e
e
k
p
r
o
g
r
a
m
c
o
m
b
i
n
i
n
g
r
e
s
i
s
t
a
n
c
e
a
n
d
a
e
r
o
b
i
c
e
x
e
r
c
i
s
e
s
,
l
e
a
d
i
n
g
t
o
w
e
i
g
h
t
r
e
d
u
c
t
i
o
n
a
n
d
e
n
h
a
n
c
e
d
i
n
s
u
l
i
n
s
e
n
s
i
t
i
v
i
t
y
[
1
8
]
.
G
o
l
e
s
t
a
n
i
e
t
a
l
.
[
1
9
]
h
ig
h
lig
h
ted
th
at
p
h
y
s
ical
ex
er
cise
is
th
e
o
p
tim
al
s
tr
ateg
y
f
o
r
r
ed
u
cin
g
to
tal
ch
o
lest
e
r
o
l
(
T
C
)
,
b
o
d
y
f
at
p
er
ce
n
tag
e
(
B
FP
)
,
lo
w
-
d
en
s
ity
lip
o
p
r
o
tein
(
L
DL
)
,
an
d
t
r
ig
l
y
ce
r
id
e
(
T
G)
.
I
n
c
r
ea
s
in
g
h
i
g
h
-
d
en
s
ity
lip
o
p
r
o
tein
(
HDL
)
s
er
v
es
as
a
p
r
o
tectiv
e
f
ac
to
r
a
g
ain
s
t
ca
r
d
i
o
v
ascu
lar
d
is
ea
s
es.
Pre
v
io
u
s
r
esear
ch
h
as
d
em
o
n
s
tr
ated
a
n
eg
ativ
e
ass
o
ciatio
n
b
etwe
en
o
m
en
tin
-
1
g
en
e
e
x
p
r
ess
io
n
an
d
o
b
esit
y
,
b
o
d
y
m
ass
,
in
s
u
lin
r
esis
tan
ce
,
an
d
lep
tin
lev
els,
alo
n
g
w
ith
a
p
o
s
i
tiv
e
r
elatio
n
s
h
ip
b
etwe
en
a
d
ip
o
n
ec
tin
an
d
HDL
[
1
2
]
.
T
h
e
s
tu
d
y
aim
s
to
f
o
c
u
s
o
n
in
v
esti
g
atin
g
th
e
e
f
f
icac
y
o
f
HI
T
in
m
o
d
u
latin
g
o
m
e
n
ti
n
-
1
g
en
e
ex
p
r
ess
io
n
,
in
s
u
lin
r
esis
tan
ce
,
an
d
lip
id
p
r
o
f
ile
in
i
n
d
iv
id
u
a
ls
with
d
iab
etes
an
d
o
b
esit
y
.
Fu
r
th
er
m
o
r
e
,
it
also
in
v
esti
g
ates
th
e
r
elatio
n
s
h
ip
s
b
etwe
en
o
m
en
tin
-
1
lev
els
an
d
in
s
u
lin
,
g
lu
co
s
e,
in
s
u
lin
r
esis
tan
ce
,
T
C
,
T
G,
HDL
,
an
d
L
DL
.
T
h
is
s
tu
d
y
co
n
tr
ib
u
tes
to
th
e
f
ield
b
y
e
x
am
in
in
g
th
e
HI
T
’
s
im
p
ac
t
o
n
o
m
en
tin
-
1
g
en
e
ex
p
r
ess
io
n
in
th
e
co
n
tex
t
o
f
d
iab
etes
an
d
o
b
esit
y
,
p
r
o
v
i
d
in
g
v
alu
a
b
le
in
s
ig
h
ts
in
to
its
p
o
ten
tial
th
er
ap
e
u
tic
ef
f
ec
ts
.
T
h
e
p
r
esen
t
s
tu
d
y
h
y
p
o
th
esizes
th
at
HI
T
will
s
ig
n
if
ican
tly
im
p
ac
t
m
etab
o
lic
an
d
m
o
lecu
lar
m
ar
k
er
s
in
r
at
m
o
d
els
with
d
iab
etes
a
n
d
o
b
esit
y
.
Sp
ec
if
ically
,
it
is
ex
p
ec
ted
t
h
at
HI
T
in
ter
v
e
n
tio
n
is
lik
ely
to
r
ed
u
ce
b
o
d
y
weig
h
t,
im
p
r
o
v
e
lip
id
p
r
o
f
iles
,
elev
ate
o
m
en
tin
-
1
g
e
n
e
ex
p
r
ess
io
n
,
lo
wer
f
asti
n
g
i
n
s
u
lin
an
d
g
lu
c
o
s
e
lev
els,
an
d
en
h
a
n
ce
in
s
u
lin
s
e
n
s
itiv
ity
co
m
p
ar
ed
to
co
n
tr
o
l a
n
d
d
iab
etic
c
o
n
tr
o
l
g
r
o
u
p
s
.
2.
M
E
T
H
O
D
2
.
1
.
E
x
perim
ent
a
l
s
et
up
T
h
ir
ty
-
two
m
ale
w
is
tar
r
ats
w
eig
h
in
g
b
etwe
en
1
1
0
-
1
2
0
g
w
er
e
s
o
u
r
ce
d
f
r
o
m
t
h
e
An
im
al
Ho
u
s
e
at
Kin
g
Sau
d
Un
iv
er
s
ity
in
R
iy
ad
h
.
Up
o
n
a
r
r
iv
al,
a
two
-
wee
k
ad
ap
tatio
n
p
er
io
d
was
im
p
lem
en
ted
to
ac
clim
ate
th
e
r
ats
to
th
eir
en
v
i
r
o
n
m
e
n
t.
T
h
e
a
n
im
als
wer
e
h
o
u
s
ed
in
p
last
ic
ca
g
es
with
m
etal
d
o
o
r
s
,
m
ea
s
u
r
in
g
2
0
×2
0
×
4
0
cm
,
ac
c
o
m
m
o
d
atin
g
f
o
u
r
r
ats
p
er
ca
g
e.
T
h
e
r
o
o
m
co
n
d
itio
n
s
wer
e
m
ain
tai
n
ed
at
a
tem
p
er
atu
r
e
o
f
20
-
2
4
°C
,
h
u
m
id
ity
r
an
g
in
g
f
r
o
m
5
0
-
6
5
%,
an
d
a
lig
h
t
-
d
a
r
k
cy
cle
o
f
1
2
h
o
u
r
s
ea
ch
.
Ster
i
lizatio
n
p
r
o
ce
d
u
r
es
wer
e
r
ig
o
r
o
u
s
ly
f
o
llo
we
d
th
r
o
u
g
h
o
u
t th
e
ex
p
er
im
en
t to
en
s
u
r
e
co
n
s
is
ten
t h
y
g
ien
e
an
d
clea
n
lin
ess
s
tan
d
ar
d
s
.
B
ef
o
r
e
co
m
m
en
ci
n
g
th
e
e
x
p
er
im
en
t,
all
an
im
als
u
n
d
er
we
n
t
an
ad
ap
tatio
n
p
er
io
d
to
ac
cli
m
ate
to
th
e
ex
p
er
im
en
tal
co
n
d
itio
n
s
.
Du
r
in
g
th
is
p
er
io
d
,
t
h
ey
wer
e
p
r
o
v
id
ed
with
a
n
o
r
m
al
d
iet
(
c
o
m
m
er
cial
f
o
d
d
er
)
o
b
tain
ed
f
r
o
m
t
h
e
C
o
lleg
e
o
f
Ag
r
icu
ltu
r
e
an
d
Vete
r
in
ar
y
M
ed
icin
e
at
Kin
g
Sau
d
Un
iv
er
s
i
ty
.
A
to
tal
o
f
eig
h
t
r
ats
wer
e
ass
ig
n
ed
to
th
e
co
n
t
r
o
l
g
r
o
u
p
,
wh
ich
r
ec
eiv
e
d
a
n
o
r
m
al
d
iet
th
r
o
u
g
h
o
u
t
t
h
e
s
tu
d
y
.
T
h
e
r
est
o
f
th
e
r
ats
wer
e
f
ed
a
h
ig
h
-
f
at
d
iet,
u
tili
zin
g
Diet
D1
2
4
5
1
,
co
m
p
r
is
in
g
2
0
%
k
ca
l
p
r
o
tein
,
3
5
%
k
ca
l
ca
r
b
o
h
y
d
r
ates,
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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lth
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2252
-
8
8
0
6
E
xp
lo
r
in
g
o
men
tin
-
1
g
e
n
e
ex
p
r
ess
io
n
a
n
d
in
s
u
lin
-
r
esis
ta
n
ce
mo
d
u
la
tio
n
i
n
…
(
N
o
o
r
a
h
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a
l
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l
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o
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a
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353
an
d
4
5
%
k
ca
l
f
at
f
o
r
eig
h
t
w
ee
k
s
,
as
d
escr
ib
ed
b
y
Mo
r
r
is
o
n
et
a
l
.
[
2
0
]
.
All
r
ats
wer
e
a
llo
wed
u
n
r
estricte
d
ac
ce
s
s
to
wate
r
an
d
f
o
o
d
.
Diab
etes
co
n
d
itio
n
was
tr
ig
g
e
r
ed
in
1
6
r
ats
th
r
o
u
g
h
th
e
in
je
ctio
n
o
f
s
tr
ep
to
z
o
to
cin
at
a
d
o
s
ag
e
o
f
6
0
m
g
/k
g
b
o
d
y
weig
h
t
d
is
s
o
lv
e
d
in
0
.
0
9
m
g
citr
ate
b
u
f
f
er
with
a
p
H
o
f
4
.
5
,
ad
m
in
is
ter
ed
in
tr
ap
er
ito
n
ea
lly
,
f
o
llo
win
g
th
e
p
r
o
to
c
o
l
o
u
tlin
e
d
b
y
Altu
n
et
a
l
.
[
2
1
]
.
Af
ter
7
2
h
o
u
r
s
o
f
d
iab
etic
in
d
u
ctio
n
,
b
lo
o
d
s
am
p
les
wer
e
co
llected
f
r
o
m
th
e
tails
o
f
th
e
r
ats
to
ch
ec
k
b
lo
o
d
g
lu
co
s
e
le
v
els
u
s
in
g
a
g
lu
co
m
eter
.
R
ats
with
b
lo
o
d
g
lu
c
o
s
e
v
a
l
u
e
s
e
x
c
e
e
d
i
n
g
3
0
0
m
g
/
d
l
w
e
r
e
c
a
t
e
g
o
r
i
z
e
d
a
s
d
i
a
b
e
t
i
c
,
f
o
l
l
o
w
i
n
g
t
h
e
c
r
i
t
e
r
i
a
e
s
t
a
b
l
i
s
h
e
d
b
y
A
l
i
z
a
d
e
h
e
t
a
l
.
[
1
2
]
.
Su
b
s
eq
u
en
tly
,
th
e
d
iab
etic
r
ats
wer
e
ca
teg
o
r
ized
in
to
t
wo
g
r
o
u
p
s
:
th
e
d
iab
etic
co
n
tr
o
l
g
r
o
u
p
,
co
m
p
r
is
in
g
eig
h
t
r
ats
with
a
m
ea
n
weig
h
t
o
f
(
2
6
4
.
8
±
4
.
4
7
)
g
r
am
s
,
an
d
th
e
HI
T
d
iab
etic
g
r
o
u
p
,
co
n
s
is
tin
g
o
f
eig
h
t r
ats with
an
av
er
ag
e
wei
g
h
t o
f
(
2
7
3
.
4
±
3
.
1
3
)
g
r
am
s
.
T
h
e
r
em
ain
in
g
eig
h
t r
ats,
wh
ich
wer
e
n
o
t in
d
u
ce
d
to
d
ev
elo
p
d
iab
etes,
wer
e
ass
ig
n
ed
to
th
e
HI
T
Ob
ese
g
r
o
u
p
.
2
.
2
.
H
I
T
pro
t
o
c
o
l
T
h
e
HI
T
d
iab
etic
a
n
d
H
I
T
Ob
ese
g
r
o
u
p
s
u
n
d
er
wen
t
a
tr
ain
in
g
p
r
o
to
c
o
l
u
s
in
g
a
5
-
lan
e
tr
ea
d
m
ill
d
esig
n
ed
f
o
r
r
ats.
I
n
itially
,
f
o
r
o
n
e
wee
k
,
th
e
y
u
n
d
er
wen
t
f
i
v
e
s
ess
io
n
s
o
f
ad
ap
tatio
n
to
th
e
d
ev
ice,
r
u
n
n
in
g
at
s
p
ee
d
s
r
an
g
in
g
f
r
o
m
0
to
1
5
m
/m
in
f
o
r
1
5
m
i
n
u
tes,
aim
ed
at
f
am
iliar
izin
g
th
em
with
t
h
e
tr
ea
d
m
ill
s
etu
p
.
Su
b
s
eq
u
en
tly
,
a
h
ea
tin
g
p
h
ase
o
f
5
m
i
n
u
tes
f
o
llo
wed
b
y
a
co
o
lin
g
p
h
ase
at
a
s
p
ee
d
o
f
0
to
1
0
m
/m
in
f
o
r
5
m
in
u
tes
was
im
p
lem
en
ted
to
p
r
ep
ar
e
th
e
an
im
als
f
o
r
th
e
s
u
b
s
eq
u
en
t
tr
ain
in
g
r
eg
im
e
n
,
as
d
escr
ib
ed
b
y
Kar
tin
ah
et
a
l
.
[
2
2
]
.
Af
ter
th
e
ad
ap
tatio
n
p
er
io
d
,
th
e
r
ats
u
n
d
er
wen
t
a
c
o
n
tin
u
o
u
s
tr
ain
in
g
p
r
o
g
r
am
f
o
r
f
iv
e
co
n
s
ec
u
tiv
e
wee
k
s
,
with
ea
ch
wee
k
co
n
s
is
tin
g
o
f
f
iv
e
s
ess
io
n
s
.
Du
r
in
g
th
ese
s
e
s
s
io
n
s
,
th
e
an
im
als
w
er
e
s
u
b
jecte
d
to
a
tr
ain
in
g
d
u
r
atio
n
at
a
s
p
ee
d
o
f
3
4
m
/m
in
f
o
r
6
0
m
in
u
tes
,
as r
ep
o
r
ted
b
y
Kim
et
a
l
.
[
2
3
]
.
2
.
3
.
O
bt
a
ini
ng
blo
o
d sa
m
ples
a
nd
a
uto
ps
ies
Ob
tain
in
g
b
lo
o
d
s
am
p
les
an
d
p
er
f
o
r
m
in
g
au
to
p
s
ies
wer
e
ca
r
r
ied
o
u
t
f
o
llo
win
g
estab
li
s
h
ed
p
r
o
ce
d
u
r
es.
Af
ter
f
in
al
tr
ain
in
g
an
d
f
o
llo
win
g
a
7
2
-
h
o
u
r
r
ec
o
v
e
r
y
p
er
io
d
,
th
e
r
ats
wer
e
s
u
b
jecte
d
t
o
an
esth
esia
u
s
in
g
ch
lo
r
o
f
o
r
m
i
n
h
alatio
n
,
as
d
escr
ib
ed
b
y
Ag
u
wa
et
a
l
.
[
2
4
]
.
B
lo
o
d
s
am
p
le
s
wer
e
tak
en
f
r
o
m
p
o
s
ter
io
r
v
ein
o
f
th
e
r
ats'
ey
es
u
s
in
g
ca
p
illar
y
t
u
b
es
a
n
d
im
m
ed
iately
tr
a
n
s
f
er
r
ed
in
to
g
el
an
d
clo
t
ac
tiv
ato
r
tu
b
es
to
f
ac
ilit
ate
ap
p
r
o
p
r
iate
p
r
eser
v
atio
n
a
n
d
an
al
y
s
is
o
f
th
e
s
am
p
les.
B
ef
o
r
e
b
lo
o
d
co
ll
ec
tio
n
,
th
e
an
im
als
u
n
d
er
wen
t
a
1
2
-
h
o
u
r
f
asti
n
g
p
er
io
d
to
en
s
u
r
e
co
n
s
is
ten
t
co
n
d
itio
n
s
.
T
h
e
b
lo
o
d
s
am
p
les
wer
e
ce
n
tr
if
u
g
ed
at
a
s
p
ee
d
o
f
4
,
0
0
0
r
p
m
f
o
r
1
5
m
in
u
tes
to
o
b
tain
p
lasma
.
Af
ter
b
lo
o
d
co
llectio
n
,
th
e
a
n
im
als
wer
e
ca
r
ef
u
lly
d
is
s
ec
ted
,
an
d
s
am
p
les
o
f
v
is
ce
r
al
f
at
wer
e
ex
cised
.
T
h
ese
f
at
s
am
p
les
we
r
e
th
en
th
o
r
o
u
g
h
ly
wash
e
d
with
is
o
to
n
ic
s
alin
e
s
o
lu
ti
o
n
to
r
em
o
v
e
an
y
ex
tr
an
eo
u
s
co
n
tam
in
a
n
ts
.
T
h
e
clea
n
ed
s
am
p
les
wer
e
s
u
b
s
e
q
u
en
tly
p
lace
d
in
cr
y
o
tu
b
es
a
n
d
s
to
r
ed
in
liq
u
id
n
itro
g
en
t
o
m
ain
tain
t
h
eir
m
o
l
ec
u
lar
in
teg
r
ity
,
f
o
llo
win
g
th
e
p
r
o
to
co
ls
o
u
tlin
ed
b
y
Alizad
e
h
et
a
l
.
[
1
2
]
.
All
an
im
als
wer
e
h
u
m
an
e
ly
s
ac
r
if
iced
f
o
llo
win
g
a
p
p
r
o
v
ed
eth
ical
g
u
id
elin
es.
T
h
e
r
em
a
in
s
o
f
th
e
an
im
als
wer
e
ap
p
r
o
p
r
iately
d
i
s
p
o
s
ed
o
f
b
y
in
cin
e
r
atio
n
in
t
h
e
in
cin
er
ato
r
o
f
th
e
C
o
lleg
e
o
f
Ag
r
icu
ltu
r
e
an
d
Vete
r
in
ar
y
Me
d
icin
e
o
f
Qass
im
Un
iv
er
s
ity
,
ad
h
er
in
g
to
p
r
o
p
er
waste
m
an
ag
em
en
t
p
r
a
ctice
s
.
Fin
ally
,
in
co
m
p
lian
ce
with
lo
ca
l la
ws an
d
r
eg
u
latio
n
s
,
th
e
an
im
al
r
em
a
in
s
wer
e
b
u
r
ied
d
ee
p
ly
[
2
5
]
.
2
.
4
.
M
ea
s
urem
ent
o
f
ins
uli
n
,
g
luco
s
e,
ins
uli
n r
esis
t
a
nce,
a
nd
lip
id
pro
f
ile
I
n
s
u
lin
lev
e
ls
wer
e
q
u
an
tifie
d
u
s
in
g
th
e
l
iais
o
n
-
in
s
u
lin
as
s
ay
(
DiaSo
r
in
Salu
g
g
ia,
I
taly
)
with
th
e
L
I
AI
SON®XL
m
o
d
el
n
u
m
b
er
1
0
0
5
0
an
d
th
e
co
b
as
i
n
teg
r
a
s
y
s
tem
(
m
an
u
f
ac
t
u
r
ed
in
Ger
m
an
y
,
d
is
tr
ib
u
ted
i
n
th
e
USA
b
y
R
o
ch
e
Diag
n
o
s
tics
,
I
n
d
ian
ap
o
lis
)
f
o
r
t
h
e
m
e
asu
r
em
en
t
o
f
g
lu
co
s
e,
T
C
,
T
G,
HDL
,
an
d
L
D
L
lev
els.
T
h
e
Ho
m
eo
s
tasi
s
Mo
d
el
Ass
es
s
m
en
t
o
f
I
n
s
u
lin
R
esis
tan
ce
(
HOM
A
-
I
R
)
f
o
r
m
u
la
was
u
s
ed
to
ass
ess
in
s
u
lin
r
es
is
tan
ce
[
1
2
]
(
p
.
3
1
)
.
T
h
e
f
o
r
m
u
la
b
elo
w
was u
s
ed
f
o
r
ca
lcu
latin
g
HOM
A
-
I
R
in
d
e
x
:
HOM
A
-
I
R
=
(
f
asti
n
g
p
lasma
in
s
u
lin
[
m
icr
o
u
n
it/mL
]
)
×
(
f
asti
n
g
p
lasma
g
lu
c
o
s
e
[
m
g
/d
L
]
)
/
4
0
5
Om
en
tin
-
1
g
e
n
e
ex
p
r
ess
io
n
m
en
s
u
r
atio
n
.
T
h
e
r
ea
l
-
tim
e
q
u
an
titativ
e
p
o
ly
m
er
ase
ch
ai
n
r
ea
ctio
n
(
R
T
-
PC
R
)
was u
s
ed
to
ass
ess
th
e
Om
en
ti
n
-
1
g
e
n
e
ex
p
r
ess
io
n
.
2
.
5
.
RNA
ex
t
ra
ct
io
n
T
is
s
u
e
h
o
m
o
g
e
n
izatio
n
was
p
er
f
o
r
m
ed
t
o
e
n
s
u
r
e
ice
r
e
m
o
v
al.
A
c
o
lu
m
n
-
b
ased
tech
n
iq
u
e
(
B
I
O
B
ASI
C
,
C
an
ad
a)
was
u
s
ed
to
ex
tr
ac
t
t
o
tal
R
N
A
f
r
o
m
v
is
ce
r
al
tis
s
u
es.
cDN
A
s
y
n
t
h
esis
an
d
R
T
-
P
C
R
p
r
ep
ar
atio
n
.
T
h
e
u
ltr
a
v
io
let
s
p
ec
tr
o
p
h
o
to
m
eter
(
PC
R
m
ax
L
am
b
ad
a,
J
ap
an
)
was
u
s
ed
to
d
eter
m
in
e
DNA’
s
co
n
ce
n
tr
atio
n
.
C
o
m
p
lem
en
tar
y
DNA
(
cDN
A)
s
y
n
th
esis
w
as
ca
r
r
ied
o
u
t
u
s
in
g
5
0
0
n
g
o
f
R
NA
f
r
o
m
ea
c
h
s
am
p
le.
Fo
r
q
R
T
-
PC
R
,
SY
B
R
Pre
m
ix
E
x
T
aq
was
em
p
l
o
y
ed
.
Om
en
tin
-
1
was
s
elec
ted
as
th
e
tar
g
et
g
en
e
,
wh
ile
b
eta
2
m
icr
o
g
lo
b
u
li
n
(
B
2
M)
was
co
n
s
id
er
ed
as
r
ef
er
en
ce
g
en
e
f
o
r
n
o
r
m
aliza
tio
n
(
T
aKa
R
a
I
n
c.
,
J
ap
an
)
u
s
in
g
th
e
R
o
to
r
-
Gen
e
6
0
0
0
q
PC
R
m
ac
h
in
e
(
Qiag
en
,
Ger
m
an
y
)
.
T
h
e
p
r
im
er
s
u
s
ed
f
o
r
B
2
M
an
d
o
m
en
tin
in
clu
d
e;
F
-
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-
GC
T
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C
C
T
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3
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an
d
R
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AAT
AGAG
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C
AT
C
T
T
G
T
GC
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an
d
F
-
5′
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Evaluation Warning : The document was created with Spire.PDF for Python.
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1
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Ma
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C
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r
esp
ec
tiv
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h
e
r
elativ
e
g
en
e
ex
p
r
ess
io
n
s
wer
e
d
eter
m
in
e
d
u
s
in
g
th
e
2
^−
Δ
Δ
C
T
m
eth
o
d
[
2
6
]
.
∆
=
(
)
−
(
ℎ
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∆
∆
=
∆
(
)
−
∆
(
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ℎ
=
2
^
−
∆
∆
[
12
]
(
.
31
)
.
2
.
6
.
Da
t
a
a
na
ly
s
is
Statis
t
ical
p
ac
k
ag
e
o
f
s
o
ci
al
s
cien
ce
s
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u
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eg
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ited
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r
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p
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6
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n
t
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r
o
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p
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4
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ated
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ativ
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th
e
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T
d
iab
etic
g
r
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p
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5
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0
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g
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m
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ar
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o
n
tr
o
l
d
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etic
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r
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p
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1
5
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1
1
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g
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l)
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d
th
e
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T
o
b
ese
g
r
o
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p
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1
0
7
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2
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.
5
8
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g
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l)
.
Fu
r
th
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o
r
e
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DL
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ited
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s
ig
n
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ican
t
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r
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s
e
in
b
o
th
th
e
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T
d
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etic
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r
o
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p
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0
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4
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1
.
7
3
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g
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l)
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d
th
e
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T
o
b
ese
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r
o
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p
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5
3
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2
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3
.
8
2
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g
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l)
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m
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e
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o
n
tr
o
l
g
r
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p
(
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7
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1
±
1
.
7
5
m
g
/d
l)
a
n
d
th
e
d
iab
etic
co
n
tr
o
l g
r
o
u
p
(
6
0
.
9
±
1
.
9
9
m
g
/
d
l)
.
T
h
e
H
I
T
d
iab
etic
g
r
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p
s
h
o
wed
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e
d
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ce
d
T
C
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in
cr
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s
ed
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ec
r
ea
s
ed
T
G
lev
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d
lo
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r
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m
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er
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ig
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ese
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4
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I
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wn
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r
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5
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ese
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g
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at
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r
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i
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lin
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en
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I
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Pu
b
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Hea
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Sci
I
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N:
2252
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8
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357
4.
DIS
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.
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e
ex
p
r
ess
io
n
f
u
r
th
er
p
r
o
v
id
es
ev
id
en
ce
f
o
r
th
e
p
o
ten
tial
b
en
ef
icial
ef
f
ec
ts
o
f
ex
er
cise
o
n
r
eg
u
latin
g
o
m
e
n
tin
-
1
d
i
ab
et
ic
in
d
iv
id
u
als
.
Mo
r
eo
v
er
,
o
m
en
tin
-
1
g
en
e
ex
p
r
ess
io
n
ca
n
b
e
in
f
l
u
en
ce
d
b
y
d
if
f
e
r
en
t
e
x
er
cise
m
o
d
alities
.
C
astro
et
a
l
.
[
2
8
]
in
v
esti
g
ated
th
e
ef
f
ec
ts
o
f
v
ar
io
u
s
ex
er
cises
o
n
o
m
en
tin
-
1
g
en
e
ex
p
r
ess
io
n
in
th
e
v
is
ce
r
al
tis
s
u
e
s
o
f
d
iab
etic
m
ice.
T
h
eir
s
tu
d
y
d
em
o
n
s
tr
ated
d
if
f
er
en
t
ty
p
es
o
f
ex
er
cise
-
in
d
u
ce
d
c
h
an
g
es
in
o
m
e
n
tin
-
1
g
en
e
ex
p
r
ess
io
n
,
h
ig
h
lig
h
tin
g
th
e
ex
er
cise
-
s
p
ec
if
ic
ef
f
ec
ts
o
n
o
m
en
tin
-
1
r
eg
u
latio
n
.
T
h
ese
co
llectiv
e
f
in
d
in
g
s
u
n
d
er
s
co
r
e
th
e
p
o
ten
tial
r
o
le
o
f
e
x
er
cise,
p
a
r
ticu
lar
ly
HI
T
,
in
m
o
d
u
latin
g
o
m
e
n
tin
-
1
g
e
n
e
e
x
p
r
ess
io
n
in
t
h
e
co
n
tex
t
o
f
d
iab
etes.
W
h
ile
o
u
r
s
tu
d
y
f
o
cu
s
ed
o
n
r
ats,
t
h
e
r
esu
lts
ar
e
co
n
s
is
ten
t
with
p
r
ev
io
u
s
r
esear
ch
in
h
u
m
a
n
s
,
s
u
g
g
esti
n
g
th
e
tr
an
s
latio
n
al
r
e
l
e
v
a
n
c
e
o
f
o
u
r
f
i
n
d
i
n
g
s
.
A
s
i
m
i
l
a
r
s
t
u
d
y
i
n
v
e
s
t
i
g
a
t
e
d
t
h
e
i
m
p
a
c
t
o
f
H
I
T
t
r
a
i
n
i
n
g
f
o
r
8
w
e
e
k
s
o
n
i
n
s
u
l
i
n
r
e
s
i
s
t
a
n
c
e
a
n
d
o
m
e
n
t
i
n
-
1
g
e
n
e
e
x
p
r
e
s
s
i
o
n
a
n
d
s
h
o
w
e
d
a
n
i
n
c
r
e
a
s
e
i
n
i
t
s
g
e
n
e
e
x
p
r
e
s
s
i
o
n
i
n
o
b
e
s
e
a
n
d
d
i
a
b
e
t
i
c
r
a
t
s
[
1
2
]
.
S
u
r
p
r
i
s
i
n
g
l
y
,
t
h
e
s
t
u
d
y
f
o
u
n
d
t
h
a
t
t
h
e
c
o
n
c
e
n
t
r
a
t
i
o
n
o
f
o
m
e
n
t
i
n
-
1
e
x
p
r
e
s
s
i
o
n
d
i
d
n
o
t
s
h
o
w
a
n
y
s
i
g
n
i
f
i
c
a
n
t
c
h
a
n
g
e
s
f
o
l
l
o
w
i
n
g
t
h
e
f
i
v
e
-
w
e
e
k
H
I
T
i
n
t
e
r
v
e
n
t
i
o
n
.
T
h
e
s
e
r
e
s
u
l
t
s
a
r
e
i
n
a
g
r
e
e
m
e
n
t
w
i
t
h
U
r
b
a
n
o
v
á
e
t
a
l
.
[
2
9
]
,
wh
er
e
th
e
s
tu
d
y
o
b
s
er
v
e
d
n
o
alter
ati
o
n
in
o
m
e
n
tin
-
1
lev
els
af
ter
tr
ain
in
g
p
r
o
g
r
am
o
f
th
r
ee
m
o
n
t
h
s
d
u
r
atio
n
,
d
esp
ite
th
e
p
o
s
itiv
e
im
p
ac
t
o
n
h
o
r
m
o
n
al
an
d
b
io
c
h
em
ical
p
ar
am
eter
s
in
h
u
m
an
s
.
An
o
th
e
r
s
tu
d
y
in
v
esti
g
ated
th
e
im
p
ac
t
o
f
HI
T
o
n
in
s
u
lin
r
esis
tan
ce
,
o
m
en
tin
-
1
lev
el,
an
d
lip
id
p
r
o
f
ile
am
o
n
g
d
iab
etic
an
d
o
b
ese
h
u
m
a
n
m
ales.
T
h
e
f
i
n
d
in
g
s
we
r
e
in
a
g
r
ee
m
en
t
with
th
e
p
r
esen
t
s
tu
d
y
as 1
2
wee
k
s
o
f
HI
T
tr
ai
n
in
g
im
p
r
o
v
ed
lev
els
o
f
o
m
en
tin
-
1
,
in
s
u
lin
s
en
s
itiv
ity
,
an
d
lip
id
p
r
o
f
ile
[
3
0
]
.
On
th
e
o
th
er
h
an
d
,
o
u
r
r
esu
lt
co
n
tr
ad
icts
th
e
f
in
d
in
g
s
o
f
Alizad
eh
et
a
l
.
[
1
2
]
,
d
em
o
n
s
tr
atin
g
h
ig
h
lev
els
o
f
o
m
en
tin
-
1
g
en
e
ex
p
r
ess
io
n
in
o
b
ese
r
a
ts
af
ter
8
wee
k
s
o
f
h
ig
h
-
in
ten
s
ity
in
ter
v
al
t
r
ain
in
g
(
HI
I
T
)
.
I
t
is
im
p
o
r
tan
t
to
n
o
te
th
at
o
m
en
tin
-
1
is
a
co
m
p
lex
ad
ip
o
k
in
e
th
at
af
f
ec
ts
d
if
f
er
en
t
p
h
y
s
io
lo
g
ical
p
r
o
ce
s
s
es,
lik
e
in
s
u
lin
r
esi
s
tan
ce
an
d
in
f
lam
m
atio
n
.
T
h
e
r
e
g
u
latio
n
o
f
o
m
en
tin
-
1
ex
p
r
ess
io
n
is
s
till
n
o
t
f
u
ll
y
u
n
d
er
s
to
o
d
,
an
d
it
ap
p
ea
r
s
to
b
e
in
f
lu
en
ce
d
b
y
m
u
ltip
l
e
f
ac
to
r
s
,
in
clu
d
in
g
ex
er
cise m
o
d
ality
,
d
u
r
atio
n
,
a
n
d
in
d
i
v
id
u
al
ch
a
r
ac
ter
is
tics
.
T
h
e
lack
o
f
o
m
en
tin
-
1
g
en
e
e
x
p
r
ess
io
n
in
th
e
HI
T
o
b
ese
g
r
o
u
p
in
our
s
tu
d
y
m
ay
b
e
attr
ib
u
ted
to
th
e
o
n
g
o
in
g
s
tate
o
f
o
b
esit
y
am
o
n
g
th
e
r
ats.
A
lo
n
g
er
d
u
r
atio
n
o
f
tr
ain
in
g
m
a
y
b
e
r
e
q
u
ir
ed
t
o
elicit
ch
a
n
g
es
in
o
m
en
tin
-
1
ex
p
r
ess
io
n
.
T
h
is
n
o
tio
n
is
s
u
p
p
o
r
ted
b
y
Am
an
at
et
a
l
.
[
2
7
]
,
wh
o
d
e
m
o
n
s
tr
ate
d
th
at
r
esis
tan
ce
o
r
ae
r
o
b
ic
ex
er
cise
o
v
er
1
2
wee
k
s
r
esu
lted
in
weig
h
t
lo
s
s
,
lead
in
g
to
in
cr
ea
s
ed
lev
els
o
f
o
m
en
tin
-
1
.
Fu
r
th
er
m
o
r
e
,
a
s
tu
d
y
co
n
d
u
c
ted
b
y
L
i
et
al
.
[
1
1
]
p
r
o
v
i
d
ed
ev
id
en
ce
th
at
co
n
s
is
ten
t
ad
h
er
en
ce
to
d
aily
ex
er
cise
r
eg
im
en
s
ca
n
r
eg
u
la
te
b
o
d
y
c
o
m
p
o
s
itio
n
,
th
er
eb
y
in
f
lu
en
ci
n
g
th
e
le
v
el
o
f
o
m
en
tin
-
1
in
s
er
u
m
.
Sp
ec
if
ically
,
in
cr
ea
s
ed
lev
els
o
f
o
m
e
n
tin
-
1
in
s
er
u
m
wer
e
o
b
s
er
v
ed
af
ter
twelv
e
wee
k
s
o
f
ex
er
cise,
co
n
s
is
tin
g
o
f
f
iv
e
s
ess
io
n
s
p
er
wee
k
o
f
m
ed
iu
m
co
n
tin
u
o
u
s
tr
ain
in
g
(
MCT)
an
d
HI
I
T
.
T
h
is
in
d
icat
es
th
at
lo
n
g
er
a
n
d
m
o
r
e
r
eg
u
la
r
ex
er
cise
p
r
o
g
r
a
m
s
m
ay
b
e
n
ec
ess
ar
y
to
in
d
u
ce
ch
an
g
es
in
o
m
en
tin
-
1
ex
p
r
ess
io
n
.
Mo
r
eo
v
er
,
R
o
s
s
et
a
l
.
[
3
1
]
c
o
n
d
u
cted
a
s
tu
d
y
in
v
o
l
v
in
g
b
o
th
MCT
an
d
HI
I
T
a
n
d
f
o
u
n
d
th
at
th
ese
ex
er
cise
m
o
d
alities
r
esu
lted
in
a
d
ec
r
ea
s
e
i
n
th
e
to
tal
p
er
ce
n
ta
g
e
o
f
b
o
d
y
an
d
l
eg
f
at,
as
well
as
a
r
e
d
u
ctio
n
in
s
u
b
cu
tan
e
o
u
s
f
at
ac
cu
m
u
latio
n
,
af
ter
twelv
e
w
ee
k
s
o
f
tr
ain
i
n
g
.
T
h
ese
f
in
d
i
n
g
s
s
u
g
g
est
th
at
s
u
s
tain
ed
ex
e
r
cise
r
eg
im
en
s
th
at
co
m
b
in
e
MCT
a
n
d
HI
I
T
h
a
v
e
th
e
p
o
ten
tial
to
p
o
s
itiv
ely
im
p
ac
t
b
o
d
y
c
o
m
p
o
s
itio
n
,
w
h
ich
m
ay
,
in
tu
r
n
,
in
f
lu
en
ce
o
m
en
tin
-
1
lev
els.
Ad
ip
o
s
e
tis
s
u
e
s
er
v
es
as
th
e
p
r
im
ar
y
s
o
u
r
ce
o
f
Om
en
tin
-
1
p
r
o
d
u
ctio
n
,
an
d
its
lev
els
ar
e
i
n
f
lu
en
ce
d
b
y
th
e
ex
p
an
s
io
n
o
r
r
e
d
u
ctio
n
o
f
ad
ip
o
s
e
tis
s
u
e.
T
h
er
e
is
p
r
o
life
r
atio
n
o
f
f
at
ce
lls
d
u
e
to
i
n
cr
ea
s
e
in
ad
ip
o
s
e
tis
s
u
e,
r
esu
ltin
g
in
in
cr
ea
s
ed
s
ec
r
etio
n
o
f
p
ro
-
in
f
lam
m
ato
r
y
ad
ip
o
k
in
es
an
d
d
ec
r
ea
s
e
in
an
ti
-
in
f
lam
m
ato
r
y
ad
ip
o
k
in
es.
C
o
n
s
eq
u
e
n
tly
,
th
e
s
ize
o
f
f
at
ce
lls
p
lay
s
a
cr
u
ci
al
r
o
le
in
r
eg
u
latin
g
Om
e
n
tin
-
1
lev
els.
HI
I
T
h
as
b
ee
n
s
h
o
wn
to
e
f
f
ec
tiv
ely
r
e
d
u
ce
v
is
ce
r
al
f
at
in
i
n
d
iv
id
u
a
ls
with
o
b
esit
y
.
T
h
is
r
e
d
u
c
tio
n
in
v
is
ce
r
al
f
at
is
lin
k
ed
with
im
p
r
o
v
e
d
in
d
icat
o
r
s
o
f
m
etab
o
lic
s
y
n
d
r
o
m
e
,
al
o
n
g
with
in
cr
ea
s
ed
lev
els
o
f
Om
en
tin
-
1
[
1
9
]
.
B
y
en
g
ag
in
g
in
HI
I
T
,
o
b
ese
in
d
iv
id
u
als
ca
n
ex
p
er
ien
ce
a
r
ed
u
ct
io
n
in
f
at
d
ep
o
s
itio
n
ar
o
u
n
d
th
eir
in
ter
n
al
o
r
g
an
s
,
lead
in
g
to
b
en
ef
icial
ch
an
g
e
s
in
m
etab
o
lic
h
ea
lth
.
T
h
is
d
ec
r
ea
s
e
in
v
is
ce
r
al
f
at
is
a
cc
o
m
p
an
ied
b
y
an
u
p
r
eg
u
lat
io
n
o
f
Om
en
ti
n
-
1
,
h
av
in
g
an
ti
-
i
n
f
lam
m
ato
r
y
ef
f
ec
t
s
th
at
r
esu
lt
in
am
elio
r
atio
n
o
f
m
etab
o
lic
d
y
s
r
eg
u
latio
n
.
T
h
ese
f
in
d
in
g
s
h
ig
h
lig
h
t
th
e
im
p
o
r
tan
ce
o
f
f
a
t
ce
ll
s
ize
an
d
it
s
in
f
lu
en
ce
o
n
Om
en
tin
-
1
lev
els.
HI
I
T
s
er
v
es
as
an
ef
f
ec
tiv
e
s
t
r
ateg
y
f
o
r
r
e
d
u
cin
g
v
is
ce
r
al
f
at,
im
p
r
o
v
in
g
m
etab
o
lic
s
y
n
d
r
o
m
e
in
d
icato
r
s
,
an
d
p
r
o
m
o
tin
g
th
e
e
x
p
r
ess
io
n
o
f
O
m
en
tin
-
1.
T
h
is
s
tu
d
y
p
r
o
v
id
es
co
m
p
elli
n
g
ev
id
e
n
ce
th
at
f
iv
e
wee
k
s
o
f
HI
I
T
r
esu
lts
in
d
ec
r
ea
s
ed
i
n
s
u
lin
an
d
b
lo
o
d
g
lu
c
o
s
e
lev
els
in
b
o
th
tr
ain
in
g
g
r
o
u
p
s
.
On
e
p
o
s
s
ib
le
m
ec
h
a
n
is
m
f
o
r
th
is
ef
f
ec
t
is
th
e
AM
P
-
ac
tiv
ated
p
r
o
tein
k
in
ase
(
AM
PK)
ac
tiv
a
tio
n
th
at
r
eg
u
lates
th
e
u
p
ta
k
e
o
f
g
lu
co
s
e
in
s
k
eleta
l
m
u
s
cle,
f
o
llo
win
g
p
h
y
s
ical
ac
tiv
ity
[
3
2
]
.
Ob
e
s
e
in
d
iv
id
u
al
s
o
f
ten
d
ev
elo
p
T
2
D
d
u
e
to
d
e
cr
ea
s
ed
lev
els
o
f
o
m
en
tin
-
1
,
a
f
ac
to
r
lin
k
ed
with
r
ed
u
ce
d
g
lu
co
s
e
u
p
tak
e
b
y
in
s
u
lin
-
r
esp
o
n
s
iv
e
tis
s
u
es
[
3
3
]
.
I
n
lin
e
with
th
ese
f
in
d
in
g
s
,
W
an
g
et
a
l
.
[
3
2
]
o
b
s
er
v
ed
im
p
r
o
v
ed
g
lu
c
o
s
e
co
n
tr
o
l
a
n
d
m
etab
o
lis
m
in
T
2
D
p
atien
ts
af
ter
en
g
a
g
in
g
in
HI
T
an
d
HI
I
T
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
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:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
1
,
Ma
r
ch
20
2
5
:
35
1
-
36
0
358
I
m
p
o
r
ta
n
tly
,
th
ey
also
n
o
ted
th
at
a
s
in
g
le
o
r
m
u
ltip
le
ex
er
cise
s
e
s
s
io
n
ca
n
h
av
e
last
i
n
g
b
en
ef
its
o
n
b
lo
o
d
g
lu
co
s
e
lev
els f
o
r
at
least 2
4
h
o
u
r
s
.
On
e
o
f
th
e
s
ig
n
if
ican
t
f
in
d
in
g
s
o
f
th
is
s
tu
d
y
is
th
e
n
o
tab
le
r
e
d
u
ctio
n
in
in
s
u
lin
r
esis
tan
ce
o
b
s
er
v
ed
in
b
o
th
t
r
ain
in
g
g
r
o
u
p
s
af
ter
e
n
g
ag
in
g
i
n
HI
T
f
o
r
f
iv
e
wee
k
s
.
T
h
is
o
u
tco
m
e
is
in
ag
r
ee
m
en
t
with
th
e
s
tu
d
y
b
y
Sp
ar
k
s
et
a
l
.
[
3
4
]
,
wh
o
c
h
ar
a
cter
ized
ex
e
r
cise
as
a
t
h
er
ap
e
u
tic
ap
p
r
o
ac
h
f
o
r
b
o
th
T
2
D
a
n
d
T
y
p
e
1
d
iab
etes
(
T
1
D)
.
E
x
er
cise
p
lay
s
a
cr
u
cial
r
o
le
in
m
o
d
u
latin
g
g
lu
c
o
s
e
h
o
m
eo
s
tasi
s
b
y
f
ac
ilit
atin
g
t
h
e
c
lear
an
ce
o
f
ex
ce
s
s
g
lu
co
s
e
an
d
im
p
r
o
v
in
g
g
lu
co
s
e
u
p
tak
e
in
s
k
eleta
l
m
u
s
cle,
th
er
eb
y
en
h
an
cin
g
in
s
u
lin
s
en
s
itiv
ity
an
d
r
ed
u
cin
g
in
s
u
lin
r
esis
tan
ce
.
T
h
ese
f
in
d
i
n
g
s
ar
e
f
u
r
t
h
er
co
r
r
o
b
o
r
ated
b
y
th
e
r
esear
ch
co
n
d
u
cted
b
y
Ku
m
ar
et
a
l
.
[
3
5
]
,
d
em
o
n
s
tr
atin
g
t
h
e
b
e
n
ef
icial
ef
f
ec
ts
o
f
r
e
g
u
lar
e
x
er
cise
in
im
p
r
o
v
i
n
g
g
lu
co
s
e
co
n
tr
o
l
a
n
d
r
ed
u
cin
g
in
s
u
lin
r
esis
tan
ce
.
I
n
cr
ea
s
ed
lev
els
o
f
in
s
u
lin
in
th
e
b
lo
o
d
s
tr
ea
m
o
f
t
en
p
r
ec
e
d
e
th
e
d
ev
elo
p
m
en
t
o
f
v
ar
io
u
s
m
etab
o
lic
d
is
o
r
d
er
s
.
T
h
e
in
v
o
l
v
em
en
t
o
f
in
s
u
lin
r
esis
tan
ce
in
th
e
d
ev
e
lo
p
m
en
t
o
f
m
etab
o
lic
s
y
n
d
r
o
m
e
is
ch
ar
ac
ter
ized
b
y
im
p
air
ed
i
n
s
u
lin
s
en
s
itiv
ity
,
f
u
r
th
er
s
u
p
p
o
r
tin
g
th
is
n
o
tio
n
.
B
y
ad
d
r
ess
in
g
in
s
u
lin
r
esis
tan
ce
th
r
o
u
g
h
ex
er
cise
in
ter
v
en
tio
n
s
s
u
ch
as
HI
T
,
th
e
r
is
k
o
f
m
etab
o
l
ic
d
is
o
r
d
er
s
ca
n
b
e
m
itig
ate
d
,
em
p
h
asizin
g
th
e
s
ig
n
if
ican
ce
o
f
m
a
n
ag
in
g
in
s
u
lin
r
esis
tan
ce
f
o
r
o
v
e
r
all
m
eta
b
o
lic
h
ea
lth
.
A
p
r
ev
i
o
u
s
s
tu
d
y
c
o
n
f
ir
m
e
d
th
at
in
cr
ea
s
ed
p
r
o
d
u
ctio
n
o
f
Om
en
tin
is
lik
ely
to
p
r
ev
en
t
t
h
e
p
r
o
g
r
ess
io
n
o
f
d
iab
etes
am
o
n
g
r
ats
[
2
8
]
.
T
h
e
im
p
ac
t
o
f
e
x
er
cise
m
ig
h
t
b
e
b
ec
au
s
e
o
f
o
m
en
tin
m
o
d
u
latio
n
,
h
o
wev
er
,
th
er
e
is
n
o
clar
ity
o
n
th
e
ca
u
s
e
-
an
d
-
ef
f
ec
t
r
elatio
n
s
h
ip
.
I
t
is
f
u
r
th
er
s
u
g
g
ested
th
at
s
k
eleta
l
m
u
s
cle
an
d
f
at
tis
s
u
e
ar
e
r
elate
d
c
o
n
c
er
n
in
g
o
m
en
tin
-
1
,
w
h
ich
ap
p
e
ar
s
to
in
f
lu
e
n
ce
g
l
u
co
s
e
m
eta
b
o
lis
m
,
p
ar
ticu
lar
l
y
in
s
u
lin
s
en
s
itiv
ity
.
An
o
th
er
s
t
u
d
y
b
y
d
e
Atash
ak
et
a
l
.
[
1
8
]
r
ep
o
r
t
in
g
th
at
1
2
wee
k
s
o
f
HI
T
im
p
r
o
v
ed
in
s
u
lin
r
esis
tan
ce
an
d
a
d
ip
o
k
in
es
(
O
m
en
tin
-
1
)
f
u
r
th
er
s
u
p
p
o
r
ted
t
h
at
HI
I
T
is
an
ef
f
ec
tiv
e
n
o
n
-
m
ed
ical
th
er
ap
eu
tic
s
tr
ateg
y
to
m
in
im
ize
ca
r
d
io
v
a
s
cu
lar
r
is
k
s
an
d
o
th
er
d
is
o
r
d
e
r
s
ca
u
s
ed
d
u
e
to
o
b
esit
y
.
On
e
s
im
ilar
s
tu
d
y
also
r
ep
o
r
ted
th
at
alter
atio
n
s
in
O
m
en
tin
-
1
lev
els
in
d
u
ce
d
b
y
ae
r
o
b
ic
ex
er
c
is
e
in
s
m
o
k
er
s
wh
o
ar
e
tr
ain
ed
in
ex
er
cise
ar
e
b
e
n
ef
icial
as
it
lo
wer
s
in
s
u
lin
r
esis
tan
ce
an
d
im
p
r
o
v
es
lip
id
p
r
o
f
iles
[
1
4
]
.
On
th
e
c
o
n
tr
ar
y
,
Go
lest
an
i
et
a
l
.
[
1
9
]
ex
am
i
n
ed
th
e
im
p
ac
t
o
f
s
p
ir
u
lin
a
c
o
m
b
in
ed
with
HI
I
T
o
n
th
e
le
v
els
o
f
O
m
en
tin
-
1
,
n
esfa
tin
-
1
,
a
n
d
lip
i
d
p
r
o
f
iles
in
o
v
er
weig
h
t
o
b
ese
f
em
ales
an
d
r
e
p
o
r
ted
elev
ated
lev
el
s
o
f
n
esfa
tin
-
1
an
d
o
m
en
tin
-
1
with
o
u
t a
f
f
ec
tin
g
th
e
lip
id
p
r
o
f
iles
.
T
h
e
f
in
d
in
g
s
o
f
Alizad
eh
et
a
l
.
[
1
2
]
r
e
v
ea
led
a
n
eg
ativ
e
c
o
r
r
elatio
n
b
etwe
en
Om
en
tin
-
1
an
d
b
lo
o
d
g
lu
co
s
e
co
n
ce
n
tr
atio
n
,
in
s
u
lin
r
esis
tan
ce
,
an
d
waist
cir
cu
m
f
er
en
ce
in
d
iab
etic
r
ats.
Ho
wev
er
,
th
ese
r
esu
lts
co
n
tr
ast
with
th
e
f
in
d
i
n
g
s
o
f
o
u
r
s
tu
d
y
,
w
h
ich
d
em
o
n
s
tr
ated
a
d
ec
r
ea
s
e
in
b
lo
o
d
in
s
u
lin
lev
els,
g
lu
co
s
e
lev
els,
an
d
in
s
u
lin
r
esis
tan
ce
,
in
b
o
t
h
th
e
HI
T
d
iab
etic
an
d
HI
T
o
b
e
s
e
g
r
o
u
p
s
.
No
tab
ly
,
d
esp
ite
th
e
lack
o
f
ch
an
g
e
in
o
m
en
tin
-
1
g
en
e
ex
p
r
ess
io
n
in
th
e
HI
T
o
b
ese
g
r
o
u
p
,
s
ig
n
if
i
ca
n
t
im
p
r
o
v
e
m
en
ts
wer
e
o
b
s
e
r
v
ed
in
g
l
u
co
s
e
an
d
in
s
u
lin
p
ar
am
eter
s
.
I
n
ter
esti
n
g
ly
,
th
e
ass
o
ciatio
n
b
etwe
en
in
s
u
lin
r
esis
tan
ce
in
p
o
s
t
-
tr
ain
in
g
d
iab
etic
in
d
iv
id
u
als
an
d
th
e
Om
e
n
tin
-
1
g
en
e
ex
p
r
ess
io
n
is
in
s
ig
n
if
ican
t
in
a
f
ew
o
f
th
e
p
r
ev
io
u
s
s
tu
d
ies
[
9
]
,
[
3
3
]
.
Similar
ly
,
th
e
s
tu
d
y
b
y
Ur
b
a
n
o
v
a
et
a
l
.
[
2
9
]
d
o
cu
m
en
ted
s
ig
n
if
ican
t
ch
an
g
es
in
weig
h
t,
in
s
u
lin
lev
els,
an
d
in
s
u
lin
r
esis
tan
ce
,
d
esp
ite
t
h
e
ab
s
en
ce
o
f
ch
a
n
g
es
in
Om
en
tin
-
1
lev
els.
T
h
ese
f
i
n
d
in
g
s
s
u
p
p
o
r
t
th
e
co
n
clu
s
io
n
s
d
r
awn
f
r
o
m
o
u
r
r
esear
ch
,
s
u
g
g
esti
n
g
th
at
th
e
r
e
g
u
lated
lev
els
o
f
g
lu
c
o
s
e
an
d
i
n
s
u
lin
d
y
n
am
ics
in
r
esp
o
n
s
e
to
ex
er
cise
m
a
y
i
n
v
o
lv
e
m
ec
h
a
n
is
m
s
in
d
ep
e
n
d
en
t
o
f
Om
en
ti
n
-
1
ex
p
r
ess
io
n
.
Ov
e
r
all,
wh
ile
p
r
ev
io
u
s
s
tu
d
ies
h
av
e
r
ep
o
r
ted
v
ar
y
i
n
g
ass
o
ciatio
n
s
b
e
twee
n
Om
en
tin
-
1
an
d
m
etab
o
lic
p
a
r
am
eter
s
,
o
u
r
s
tu
d
y
co
n
tr
ib
u
tes
to
th
e
p
r
ev
io
u
s
liter
atu
r
e
in
d
icatin
g
th
at
im
p
r
o
v
em
en
ts
in
g
l
u
co
s
e
co
n
tr
o
l,
i
n
s
u
lin
lev
els,
an
d
in
s
u
lin
r
esis
tan
ce
ca
n
b
e
ac
h
iev
ed
th
r
o
u
g
h
e
x
er
cise
in
ter
v
e
n
tio
n
s
,
ev
en
in
th
e
a
b
s
en
ce
o
f
s
ig
n
if
ican
t
ch
an
g
es
in
Om
en
tin
-
1
e
x
p
r
ess
io
n
.
On
e
o
f
th
e
k
ey
f
i
n
d
in
g
s
o
f
th
is
s
tu
d
y
is
th
e
s
ig
n
if
ican
t
d
ec
r
ea
s
e
in
T
C
,
T
G,
an
d
l
o
w
-
d
en
s
ity
lip
o
p
r
o
tein
(
L
DL
)
lev
els
in
th
e
HI
T
d
iab
etic
g
r
o
u
p
.
Ho
wev
er
,
th
er
e
wer
e
s
ig
n
if
ican
t
d
if
f
er
en
ce
s
r
ep
o
r
ted
in
th
e
HI
T
-
o
b
ese
g
r
o
u
p
.
Mo
r
eo
v
er
,
th
e
HI
T
d
iab
etic
g
r
o
u
p
ex
h
ib
ited
an
in
cr
ea
s
e
in
h
ig
h
-
d
en
s
ity
lip
o
p
r
o
tein
HDL
lev
els
co
m
p
ar
ed
to
th
e
o
th
er
g
r
o
u
p
s
af
ter
f
iv
e
wee
k
s
o
f
HI
T
.
T
h
e
r
esu
lts
o
f
th
e
lip
id
p
r
o
f
ile
an
aly
s
is
in
d
icate
a
n
e
g
ativ
e
r
elatio
n
s
h
ip
b
etwe
en
T
C
,
T
G,
an
d
L
DL
l
ev
e
ls
,
an
d
t
h
e
ex
p
r
ess
io
n
o
f
th
e
Om
en
tin
-
1
g
en
e
,
wh
ile
a
p
o
s
itiv
e
r
elatio
n
s
h
ip
was
o
b
s
er
v
ed
b
etwe
en
HDL
lev
els
an
d
Om
en
ti
n
-
1
g
en
e
e
x
p
r
ess
io
n
.
Ph
y
s
ical
in
ac
tiv
ity
,
T
2
D,
a
n
d
o
b
esit
y
,
p
ar
ticu
lar
ly
v
is
ce
r
al
o
b
esit
y
,
ar
e
k
n
o
wn
f
ac
to
r
s
co
n
tr
ib
u
ti
n
g
to
lip
id
p
r
o
f
ile
d
is
tu
r
b
an
ce
s
.
Z
h
an
g
et
a
l
.
[
3
6
]
d
em
o
n
s
tr
ated
th
at
im
p
lem
en
tin
g
an
ex
e
r
cise
p
r
o
g
r
am
led
t
o
a
d
ec
r
ea
s
e
i
n
T
C
,
L
DL
,
an
d
T
G
lev
els,
an
d
in
cr
ea
s
e
in
HDL
lev
els
in
d
iab
etic
p
atien
ts
.
Ho
wev
er
,
Go
lest
an
i
et
a
l
.
[
1
9
]
r
e
p
o
r
te
d
n
o
s
ig
n
if
ica
n
t
c
h
an
g
es
i
n
L
D
L
,
HDL
,
T
C
,
an
d
T
G
lev
els
f
o
llo
win
g
f
o
u
r
wee
k
s
o
f
in
te
r
v
al
tr
a
in
i
n
g
.
I
t
is
s
u
g
g
ested
th
at
th
e
d
u
r
atio
n
o
f
f
o
u
r
wee
k
s
m
ay
n
o
t
b
e
s
u
f
f
ici
en
t
to
in
f
lu
en
ce
lip
i
d
lev
els
an
d
it
is
em
p
h
asized
th
at
ex
er
cise in
ten
s
ity
an
d
v
o
l
u
m
e
p
lay
c
r
u
cial
r
o
les in
m
o
d
u
latin
g
L
DL
an
d
HDL
lev
els.
5.
CO
NCLU
SI
O
N
In
co
n
clu
s
io
n
,
th
e
s
tu
d
y
p
r
o
v
id
ed
s
tr
o
n
g
ev
id
e
n
ce
f
o
r
th
e
ef
f
ec
tiv
en
ess
o
f
HI
I
T
af
ter
a
5
-
wee
k
in
ter
v
en
tio
n
p
e
r
io
d
in
r
at
m
o
d
els
with
d
iab
etes
an
d
o
b
esit
y
.
T
h
e
HI
T
d
iab
etic
g
r
o
u
p
ex
h
ib
ited
a
s
ig
n
if
ican
t
in
cr
ea
s
e
in
Om
en
ti
n
-
1
g
en
e
ex
p
r
ess
io
n
as
co
m
p
a
r
ed
t
o
o
t
h
er
g
r
o
u
p
s
,
i
n
d
icatin
g
a
p
o
s
itiv
e
im
p
ac
t
o
n
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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Pu
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Hea
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Sci
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N:
2252
-
8
8
0
6
E
xp
lo
r
in
g
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tin
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1
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e
n
e
ex
p
r
ess
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a
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in
s
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lin
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r
esis
ta
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(
N
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a
h
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a
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A
l
-
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o
w
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359
m
o
lecu
lar
m
ar
k
er
s
.
Mo
r
e
o
v
er
,
b
o
th
t
h
e
HI
T
d
ia
b
etic
an
d
HI
T
o
b
ese
g
r
o
u
p
s
d
e
m
o
n
s
tr
a
ted
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g
lu
co
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in
s
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s
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esis
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o
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is
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u
r
th
er
d
em
o
n
s
tr
ated
th
e
b
e
n
ef
icial
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f
ec
ts
o
f
H
I
T
,
r
e
v
e
alin
g
d
im
in
is
h
ed
lev
els
o
f
T
C
,
T
G,
an
d
L
DL
,
ac
co
m
p
an
ied
b
y
an
elev
atio
n
in
HDL
le
v
els
in
t
h
e
HI
T
d
iab
etic
g
r
o
u
p
.
T
h
ese
f
i
n
d
in
g
s
p
r
o
v
id
e
e
v
id
en
ce
s
u
p
p
o
r
tin
g
th
e
p
o
ten
tial
o
f
HI
I
T
to
in
d
u
ce
f
av
o
r
ab
le
ch
a
n
g
es
in
k
ey
m
etab
o
lic
an
d
m
o
le
cu
lar
p
ar
am
eter
s
in
th
e
co
n
tex
t
o
f
d
iab
etes a
n
d
o
b
esit
y
in
th
e
ex
p
er
im
e
n
tal
s
ettin
g
.
RE
F
E
R
E
NC
E
S
[
1
]
E.
Ś
w
i
d
e
r
s
k
a
,
J.
S
t
r
y
c
h
a
r
z
,
A
.
W
r
ó
b
l
e
w
sk
i
,
J.
S
z
e
mr
a
j
,
J.
D
r
z
e
w
o
sk
i
,
a
n
d
A
.
Ś
l
i
w
i
ń
s
k
a
,
“
R
o
l
e
o
f
P
I
3
K
/
A
K
T
p
a
t
h
w
a
y
i
n
i
n
s
u
l
i
n
-
med
i
a
t
e
d
g
l
u
c
o
se
u
p
t
a
k
e
,
”
i
n
Bl
o
o
d
G
l
u
c
o
s
e
L
e
v
e
l
s
,
I
n
t
e
c
h
O
p
e
n
,
2
0
2
0
.
d
o
i
:
1
0
.
5
7
7
2
/
i
n
t
e
c
h
o
p
e
n
.
8
0
4
0
2
.
[
2
]
L.
J
e
a
n
-
F
r
a
n
ç
o
i
s,
A
.
D
e
r
g
h
a
l
,
a
n
d
L
.
M
o
u
n
i
e
n
,
“
M
i
c
r
o
r
n
a
s i
n
o
b
e
si
t
y
a
n
d
r
e
l
a
t
e
d
met
a
b
o
l
i
c
d
i
s
o
r
d
e
r
s,”
C
e
l
l
s
,
v
o
l
.
8
,
n
o
.
8
,
p
.
8
5
9
,
A
u
g
.
2
0
1
9
,
d
o
i
:
1
0
.
3
3
9
0
/
c
e
l
l
s
8
0
8
0
8
5
9
.
[
3
]
F
.
J.
R
u
i
z
-
O
j
e
d
a
,
A
.
M
é
n
d
e
z
-
G
u
t
i
é
r
r
e
z
,
C
.
M
.
A
g
u
i
l
e
r
a
,
a
n
d
J.
P
l
a
z
a
-
D
í
a
z
,
“
Ex
t
r
a
c
e
l
l
u
l
a
r
ma
t
r
i
x
r
e
m
o
d
e
l
i
n
g
o
f
a
d
i
p
o
se
t
i
ss
u
e
i
n
o
b
e
si
t
y
a
n
d
me
t
a
b
o
l
i
c
d
i
se
a
ses
,
”
I
n
t
e
r
n
a
t
i
o
n
a
l
J
o
u
r
n
a
l
o
f
M
o
l
e
c
u
l
a
r
S
c
i
e
n
c
e
s
,
v
o
l
.
2
0
,
n
o
.
1
9
,
p
.
4
8
8
8
,
O
c
t
.
2
0
1
9
,
d
o
i
:
1
0
.
3
3
9
0
/
i
j
ms
2
0
1
9
4
8
8
8
.
[
4
]
Y
.
Z
h
e
n
g
,
S
.
H
.
L
e
y
,
a
n
d
F
.
B
.
H
u
,
“
G
l
o
b
a
l
a
e
t
i
o
l
o
g
y
a
n
d
e
p
i
d
e
m
i
o
l
o
g
y
o
f
t
y
p
e
2
d
i
a
b
e
t
e
s
me
l
l
i
t
u
s
a
n
d
i
t
s
c
o
m
p
l
i
c
a
t
i
o
n
s,
”
N
a
t
u
re
Re
v
i
e
w
s E
n
d
o
c
ri
n
o
l
o
g
y
,
v
o
l
.
1
4
,
n
o
.
2
,
p
p
.
8
8
–
9
8
,
F
e
b
.
2
0
1
8
,
d
o
i
:
1
0
.
1
0
3
8
/
n
r
e
n
d
o
.
2
0
1
7
.
1
5
1
.
[
5
]
R
.
K
a
u
r
,
M
.
K
a
u
r
,
a
n
d
J.
S
i
n
g
h
,
“
E
n
d
o
t
h
e
l
i
a
l
d
y
sf
u
n
c
t
i
o
n
a
n
d
p
l
a
t
e
l
e
t
h
y
p
e
r
a
c
t
i
v
i
t
y
i
n
t
y
p
e
2
d
i
a
b
e
t
e
s m
e
l
l
i
t
u
s
:
M
o
l
e
c
u
l
a
r
i
n
s
i
g
h
t
s
a
n
d
t
h
e
r
a
p
e
u
t
i
c
s
t
r
a
t
e
g
i
e
s
,
”
C
a
rd
i
o
v
a
s
c
u
l
a
r
D
i
a
b
e
t
o
l
o
g
y
,
v
o
l
.
1
7
,
n
o
.
1
,
p
.
1
2
1
,
D
e
c
.
2
0
1
8
,
d
o
i
:
1
0
.
1
1
8
6
/
s
1
2
9
3
3
-
0
1
8
-
0
7
6
3
-
3.
[
6
]
A
.
D
.
A
sso
c
i
a
t
i
o
n
,
“
C
l
a
ss
i
f
i
c
a
t
i
o
n
a
n
d
d
i
a
g
n
o
s
i
s
o
f
d
i
a
b
e
t
e
s
:
S
t
a
n
d
a
r
d
s
o
f
med
i
c
a
l
c
a
r
e
i
n
D
i
a
b
e
t
e
sd
2
0
1
8
,
”
D
i
a
b
e
t
e
s
C
a
re
,
v
o
l
.
4
1
,
n
o
.
S
u
p
p
l
e
me
n
t
_
1
,
p
p
.
S
1
3
–
S
2
7
,
J
a
n
.
2
0
1
8
,
d
o
i
:
1
0
.
2
3
3
7
/
d
c
1
8
-
S
0
0
2
.
[
7
]
A
.
C
h
a
i
t
a
n
d
L
.
J.
d
e
n
H
a
r
t
i
g
h
,
“
A
d
i
p
o
se
t
i
ss
u
e
d
i
st
r
i
b
u
t
i
o
n
,
i
n
f
l
a
mm
a
t
i
o
n
a
n
d
i
t
s
m
e
t
a
b
o
l
i
c
c
o
n
s
e
q
u
e
n
c
e
s,
i
n
c
l
u
d
i
n
g
d
i
a
b
e
t
e
s a
n
d
c
a
r
d
i
o
v
a
sc
u
l
a
r
d
i
se
a
se
,
”
F
ro
n
t
i
e
rs
i
n
C
a
r
d
i
o
v
a
s
c
u
l
a
r
M
e
d
i
c
i
n
e
,
v
o
l
.
7
,
F
e
b
.
2
0
2
0
,
d
o
i
:
1
0
.
3
3
8
9
/
f
c
v
m.
2
0
2
0
.
0
0
0
2
2
.
[
8
]
J.
Le
s
n
á
e
t
a
l
.
,
“
O
me
n
t
i
n
-
1
p
l
a
s
ma
l
e
v
e
l
s
a
n
d
c
h
o
l
e
s
t
e
r
o
l
m
e
t
a
b
o
l
i
sm
i
n
o
b
e
s
e
p
a
t
i
e
n
t
s
w
i
t
h
d
i
a
b
e
t
e
s
me
l
l
i
t
u
s
t
y
p
e
1
:
I
mp
a
c
t
o
f
w
e
i
g
h
t
r
e
d
u
c
t
i
o
n
,
”
N
u
t
ri
t
i
o
n
a
n
d
D
i
a
b
e
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e
s
,
v
o
l
.
5
,
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.
1
1
,
p
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.
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8
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3
,
N
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.
2
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:
1
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[
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J.
R
.
S
p
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,
“
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[
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A
.
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a
mp
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t
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u
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l
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[
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L.
Z
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a
n
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l
.
,
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o
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M
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B
I
O
G
RAP
H
I
E
S O
F
AUTH
O
RS
No
o
r
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a
leh
Al
-
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w
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ic
sp
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p
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si
o
l
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g
y
,
c
u
rre
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o
ld
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h
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p
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siti
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n
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f
p
ro
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ss
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r
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h
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Bio
lo
g
y
De
p
a
rtme
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t
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t
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Co
ll
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g
e
o
f
S
c
ien
c
e
,
Qa
ss
im
Un
iv
e
rsity
.
In
t
h
is
ro
le,
sh
e
e
n
g
a
g
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in
re
se
a
rc
h
a
c
ti
v
it
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a
n
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d
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c
a
tes
stu
d
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ts
in
v
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rio
u
s
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sp
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f
li
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sc
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c
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s.
He
r
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tri
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tal
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tern
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lt
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ra
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s
we
ll
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s
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tri
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h
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sh
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m
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rd
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n
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d
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it
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to
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n
d
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v
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rs,
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ro
fe
ss
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r
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-
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o
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n
h
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s
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u
th
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e
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th
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o
k
ti
t
led
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z
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o
l
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y
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,
wh
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se
rv
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s
a
s
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v
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le
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rc
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fo
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ts
a
n
d
re
se
a
rc
h
e
rs
in
th
e
field
o
f
li
fe
sc
ien
c
e
s.
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is
c
o
m
p
re
h
e
n
siv
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wo
rk
d
e
l
v
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s
i
n
to
to
p
ics
su
c
h
a
s
b
io
lo
g
ica
l
d
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v
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r
sity
,
li
fe
p
ro
c
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ss
e
s,
a
n
d
e
v
o
lu
ti
o
n
,
g
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rn
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ri
n
g
p
ra
ise
fro
m
th
e
sc
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ifi
c
c
o
m
m
u
n
it
y
.
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e
r
c
o
m
m
it
m
e
n
t
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x
te
n
d
s
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d
a
c
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d
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m
ia.
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ro
fe
ss
o
r
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l
-
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o
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y
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n
a
c
ti
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ly
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ste
rs
k
n
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wle
d
g
e
a
n
d
p
r
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m
o
tes
sc
ien
ti
fic
li
tera
c
y
a
m
o
n
g
st
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d
e
n
ts
a
n
d
fe
ll
o
w
re
se
a
rc
h
e
rs,
with
t
h
e
g
o
a
l
o
f
in
sp
iri
n
g
th
e
m
t
o
e
m
b
a
rk
o
n
n
e
w
in
tellec
tu
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rn
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th
ro
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g
h
h
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r
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se
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rc
h
a
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tea
c
h
in
g
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ff
o
rts.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
n
sa
o
iea
n
@
q
u
.
e
d
u
.
sa
.
Aie
sha
Mo
h
a
m
m
e
d
Al
m
u
t
a
wa
wo
r
k
s
a
s
a
lec
tu
re
r
in
th
e
Bi
o
lo
g
y
De
p
a
rtme
n
t
a
t
Qa
ss
im
Un
iv
e
rsity
.
S
h
e
is
c
u
rr
e
n
tl
y
a
d
o
c
t
o
ra
l
stu
d
e
n
t
a
t
Kin
g
S
a
u
d
Un
iv
e
rsity
.
S
h
e
g
o
t
a
m
a
ste
r’s
d
e
g
re
e
with
a
sp
e
c
ializ
a
ti
o
n
i
n
p
h
y
si
o
lo
g
ica
l
sc
ien
c
e
,
with
a
n
e
x
c
e
ll
e
n
t
g
ra
d
e
i
n
2
0
2
2
.
S
h
e
o
b
tain
e
d
a
b
a
c
h
e
l
o
r'
s
d
e
g
re
e
in
z
o
o
l
o
g
y
fro
m
Qa
ss
im
Un
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rsity
wit
h
a
n
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x
c
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ll
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n
t
g
ra
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n
d
sh
e
h
a
s
sc
ien
ti
fic
p
u
b
li
c
a
ti
o
n
s
in
h
e
r
field
o
f
s
p
e
c
ializa
ti
o
n
.
S
h
e
sp
e
a
k
s
Ara
b
ic an
d
E
n
g
l
ish
la
n
g
u
a
g
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s.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
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:
a
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a
lmo
taw
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a
@q
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d
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sa
.
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