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The subsequent development of tirzepatide, a dual GIP and GLP-1 receptor agonist, demonstrated that targeting multiple gut hormone pathways could yield superior efficacy [9, 11]
In vascular endothelium, GLP-1R stimulation activates both cAMP/PKA and PI3K/Akt signaling cascades, leading to phosphorylation of endothelial nitric oxide synthase (eNOS) and increased nitric oxide production [4]
Patients should avoid extreme temperature exposure during the adjustment period
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