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Based on clinically available variables (BMI, waist circumference, OGTT/HOMA-IR, lipid profiles, NAFLD assessments, androgens, SHBG, and ultrasound markers), interpretable risk stratification models should be established rather than replacing clinical logic with “black-box” algorithms (173, 174)

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What isn't settled: which circuit matters most, how the balance shifts as disease severity increases, and whether every drug in the GLP-1 class engages these pathways to the same degree