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As with other incretin-based agents, these events were generally more common than with placebo and were often dose-related , particularly during the dose-escalation phase of treatment

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This can be linked to a significant reduction of serine palmitoyl transferase (SPT) protein levels and the downregulation of the ceramide-synthesis enzymes ceramide synthase 5 ( CERS5 ) and delta(4)-desaturase as well as sphingolipid 1 ( DEGS1 ) expression at both messenger-RNA and protein levels

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