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Notably, TMAO also amplifies ERS markers such as heat shock protein 60 and glucose regulated protein 78kD in macrophages, correlating with elevated toll-like receptor 4 expression and proinflammatory cytokine production (e.g., TNF-, IL-6) (88, 89)

DN screening should be repeated annually and must include sensory examination of the feet and ankle reflexes 26

doi:10.1016/j.amjoto.2021.103337

Ideally, primary patient care should be based on uniform evaluation algorithms and standardized procedures