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Furthermore, NADPH is required for many anabolic pathways such as nitric oxide and fatty acid synthesis, however, NADPH consumption in the aldose reductase pathway under diabetic conditions causes a harmful effect on the biosynthesis process of these molecules in the retina (Thakur et al., 2021)

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Therefore, selenium deficiency is associated with thyroid dysfunction and increased risk of thyroid autoimmunity and nodules [65], a condition further aggravated by the fact that concurrent iodine and selenium deficiency is rather common [66, 67]

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