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Apart from the decreased production of collagen, there is an increased activity of metalloproteinase-1, an enzyme responsible for collagen disintegration [13]
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The presence of metabolic syndrome may be a factor in whose control improvements persist, and may negatively affect asthma control, as one trial showed that those with metabolic syndrome at baseline and during follow-up (i.e., their metabolic syndrome did not resolve with surgery) had the highest risk for losing asthma control at subsequent visits, with the findings statistically significant even when adjusting for weight loss [82]
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