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This modification is a carboxylation and the enzyme responsible, -glutamyl carboxylase requires vitamin K as a cofactor

The "LR3" in IGF-1 LR3 refers to a specific modification in the protein structure, where an arginine (Arg) is substituted at the third position

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As a primary therapeutic option for adolescent PCOS, metformin, whether used either as a standalone therapy or in conjunction with oral contraceptives, can effectively reduce androgen levels, alleviate hyperandrogenism symptoms, restore regular menstrual cycles, ameliorate IR, and reduce the likelihood of long-term cardiovascular complications