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Because SAM is also required for many other methylation reactions, including gene-expression regulation, high NNMT activity draws heavily on SAM and is associated in studies with reduced NAD, a coenzyme central to cellular energy production

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The evidence base for tirzepatide as monotherapy is robust, with pivotal trials including SURMOUNT-1 demonstrating significant weight reduction in adults with obesity, and SURPASS trials establishing glycemic efficacy in type 2 diabetes