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During that time, the development of a distinct zona reticularis is accompanied by an extreme increase in the adrenal androgen precursor production due to the decreased expression of HSD3B2 in conjunction with increased CYB5A expression [[34], [35], [36], [37], [38]]

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This complexity causes significant misdiagnosis, under-diagnosis, and delayed diagnosis

TBARS, thiobarbituric acid-reactive substances