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33 The decrease in synovial DPP4 levels in RA may contribute to synovial inflammation through the SDF-1/CXCR4 axis, as the level of synovial SDF-1 was significantly correlated with inflammatory markers (serum C-reactive protein and IL-6) and disease activity score

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If you simply cant lose weight or keep it off with diet or exercise, it often indicates an underlying metabolic or hormonal factors that make weight loss particularly challenging