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Other mechanisms include increased insulin resistance induced by high-dose glucocorticoids that increases intra-portal insulin, decreases IGFBP-1 that increases free IGF-I, and direct glucocorticoid effects in increasing hepatic IGF-I synthesis and decreasing hepatic insulin clearance (105)

A total of 90 participants with FBSS and chronic pain lasting more than three months were recruited and randomly assigned into two equal groups: one group received caudal epidural prolotherapy (dextrose prolotherapy), and the other received methylprednisolone-based steroid injection

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