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Pathophysiologically, MASLD is strongly associated with insulin resistance, leading to hepatic lipid accumulation, inflammation, and in advanced stages, fibrosis and cirrhosis
doi:10.1016/j.ajo.2025.02.025 34
ROR = 1.62, 95% CI 1.51.75) Pancreatic cancer (n = 507
Oral semaglutide may feel gentler initially because it avoids the rapid injection bolus, but it still causes nausea in roughly 2025% of patients due to the same gastric-slowing mechanism
Vitamin D Vitamin D deficiency is significantly more prevalent in Hashimoto's patients compared to the general population
The anti-inflammatory pathways modulated by GLP-1 receptor activation (NF-kB suppression, macrophage polarization, Treg enhancement) are largely distinct from the pathways targeted by: Methotrexate: Folate metabolism disruption, different anti-inflammatory pathway TNF inhibitors (adalimumab, etanercept): Direct TNF blockade, whereas GLP-1 reduces TNF production upstream IL-6 inhibitors (tocilizumab): Receptor-level blockade, while GLP-1 reduces IL-6 production JAK inhibitors (tofacitinib, baricitinib): Different signaling pathway entirely Corticosteroids: Broad immunosuppression, while GLP-1 is immunomodulatory This pathway complementarity is why additive benefit is biologically plausible
