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Data ( d, f, g, j, k ) are shown as box-and-whisker plots: boxes indicate the 25th75th percentiles, central lines indicate medians, and whiskers indicate minimum to maximum values

Similarly, BCAA elevation in DKD reflects both impaired renal catabolism (reduced mitochondrial BCKDH activity) and insulin resistance-driven alterations (133), with standard eGFR adjustment being insufficient as GFR lies on the causal pathway between metabolites and outcomes