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animal experiments have confirmed that it can extend the maximum running distance and enhance muscle fatigue resistance in mice (108), and clinical studies have also observed significant increases in mitochondrial biogenesisrelated protein levels and improvements in aerobic metabolic efficiency in patients with Becker muscular dystrophy (109)

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Preclinical animal studies raise concerns about reproductive toxicity, whereas emerging human data suggest no significant increase in major congenital malformations compared with insulin