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The 2011 AASLD guidelines on hepatic encephalopathy note that hormonal perturbations accelerate muscle wasting in decompensated cirrhosis, supporting a cautious net-positive approach to GH-axis therapy but only with close monitoring (AASLD / Hepatology reference)
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Mechanistically, Ipamorelin binds to the GHS-R1a receptor , mimicking ghrelin to enhance GH secretion
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