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Prioritize protein (0.7 to 1.0 grams per pound of target body weight), eat frequent small meals rather than large infrequent ones, limit high-fat foods during dose increases to reduce nausea, stay hydrated, and avoid alcohol (which worsens both GI side effects and calorie intake)

These cytokines bind to target cells through cell surface receptors, activating signal transduction pathways and initiating a series of inflammatory cascade responses, with NF-B having been identified as a key target (25)

Their receptors are expressed on the beta cells in pancreatic islets and are also expressed in the heart, vasculature, intestines, kidney, and brain

Secondly, at the gene expression level, the reduced expression of nuclear-encoded genes in the mitochondrial oxidative phosphorylation (OXPHOS) system may mediate the occurrence and development of insulin resistance in the skeletal muscle tissue of PCOS patients, and the decreased expression of PGC-1 may be a key mediating factor (Skov et al., 2007)