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Biochemically these individuals manifest with elevated levels of polyols, particularly ribitol, D-arabitol, in body fluids and in the brain

Specifically, formaldehyde has been demonstrated to suppress the expression of synaptic plasticity-related genes in the hippocampus [81], while cigarette smoke exposure, which includes formaldehyde among its toxic constituents, has been reported to impair insulin signaling and reduce insulin receptor (I-R) expression in peripheral tissues [82]

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