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Two estimands were employed: the trial product estimand, which evaluated treatment effects assuming perfect adherence to the assigned regimen, and the treatment policy estimand, which included all randomized participants regardless of adherence

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Sirtuin 1 (SIRT1) negatively regulates GH-induced IGF-1 production in the liver by directly inhibiting signal transducer and activator of transcription 5 (STAT5) activation, which causes GH resistance under prolonged fasting, starvation, and malnutrition [6]