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In the obesity group, there was a significant and clinically meaningful reduction in body weight of 4.74% at week 8, with weight continuously decreasing during the 8-week treatment period.175 Classical pathophysiological mechanisms of GLP-1 GLP-1 signaling pathway GLP-1 initiates signaling by binding to its receptor, GLP-1R, which is a G-protein-coupled receptor.176,177 When GLP-1 binds to GLP-1R, it triggers the activation of G-proteins, leading to an increase in the intracellular second messenger cAMP.34,39,177 The rise in cAMP activates protein kinase A (PKA), which then promotes the synthesis and secretion of insulin and inhibits the release of glucagon.178,179 Additionally, cAMP can activate Rap1 through EPAC (Exchange Protein directly Activated by cAMP),180,181,182 which is involved in regulating insulin secretion.180,181,183 GLP-1 also activates the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) pathway, which is crucial for maintaining the survival and function of pancreatic -cells.184,185,186,187 GLP-1 (GLP-1RAs) GLP-1RAs , .37 GLP-1RAs , .171 GLP-1RAs GLP-1RAs ,

Studies showed that the levels of total carnitine, free carnitine, L-carnitine and C3:0 in dialysis patients were lower than those in healthy controls, while those of C4:0, isoamyl C4:0 and C18:1-OH were higher

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