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The mechanisms underlying DKD-related cognitive decline which mainly included the accumulation of harmful metabolites, inflammation activation and endothelial dysfunction were also clarified

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Tumor necrosis factor-alpha (TNF-alpha), a cytokine involved in systemic inflammation, along with matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) enzymes that break down extracellular matrix proteins might potentially influence both the inflammatory processes and the remodeling of tissues