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Among the remaining subjects, we further excluded those who received a diagnosis of bipolar disorder during the follow-up assessment (n = 9), those with missing metabolite data due to the lack of blood samples (n = 158) and those who did not complete the Inventory for Depressive Symptoms questionnaire (n = 33)

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IGF-1 LR3, by contrast, works through the classic IGF-1 receptor signaling cascade, activating the PI3K/Akt/mTOR pathway and supporting satellite cells once they have already entered the proliferative and differentiation phase