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Gut microbiota imbalance may contribute to DN, as metabolites such as short-chain fatty acids and indole derivatives can alter the renal microenvironment through immune and metabolic pathways, suggesting a regulatory role upstream of inflammation and metabolism ( The pathogenesis of DN is multifactorial, involving immune dysregulation, oxidative stress, and metabolic and hemodynamic disturbances

Even mild zinc deficiency can reduce immune cell activity and slow recovery from illness

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