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The authors say that separation between effectiveness and tolerability may point to differences between dual incretin agonism and GLP-1-only therapy

For GLP-1R, the -carboxylate spacer formed two hydrogen bonds (with Y145 1.40b and D198 2.68b ), and the 16-carbon palmitic chain terminus dropped down along TM1 with the formation of multiple strong hydrophobic interactions with I146 1.41b , T149 1.44b , V150 1.45b , A153 1.48b and L154 1.49b

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In research models, these peptides stimulate growth hormone (GH) release by activating the ghrelin/GHS-R receptor

These mitochondrial impairments are closely associated with the disruption of energy metabolism and neuronal death