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Moreover, elevated insulin levels resulting from hyperinsulinemia trigger insulin-like growth factor (IGF) signaling, activating key pathways such as phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) and mitogen-activated protein kinase (MAPK) [26]

Nodules are abnormal growths in the thyroid

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