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This occurs via the lipid metabolism hub gene Phospholipase A2 Group IIA in homoeostatic chondrocytes, a Phospholipase A2 enzyme that promotes OA pathology by increasing arachidonic acid release and activating downstream pro-inflammatory pathways (Wang Y

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Schernthaner and Schernthaner, 2020), metformin is associated with gastrointestinal side effects in around 20% of patients, including nausea, vomiting, diarrhea, bloating, and occasionally lactic acidosis and vitamin B12 malabsorption