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Possible contributing factors to muscle mass reduction and sarcopenia in liver cirrhosis include elevated serum ammonia, impaired protein synthesis, reduced anabolic hormones, and an inflammatory state in liver cirrhosis [18]

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One study showed that insulins ability to induce glycogen synthesis was dependent on this hormones ability to inhibit phosphorylase activity - the stimulation of glucose uptake and glycogen synthase was not enough to promote net glycogen synthesis

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PRISMA, preferred reporting items for systematic reviews and meta-analyses