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Evidence from community-based cohorts has shown that higher body mass index and insulin resistance may be strongly associated with future HFpEF, especially among women (Savji et al., 2018)

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It remains to be determined whether differences in barrier permeability are associated with comorbid anxiety or depression in GERD patients, which should be further validated through clinical data analysis and animal experiments to establish a causal link between metabolite-mediated barrier disruption and GERD comorbidities