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Among the remaining subjects, we further excluded those who received a diagnosis of bipolar disorder during the follow-up assessment (n = 9), those with missing metabolite data due to the lack of blood samples (n = 158) and those who did not complete the Inventory for Depressive Symptoms questionnaire (n = 33)

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It binds to multiple melanocortin receptors (MC1R, MC3R, MC4R, MC5R) throughout the body and brain, leading to more widespread physiological effects than the highly selective Melanotan 1