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Although direct clinical evidence of systemic NAD(P) depletion during GLP-1RA therapy is lacking, experimental and observational studies suggest that NAD turnover and micronutrient status can be altered in obesity and inflammatory states [83, 85], supporting the biological plausibility of substrate-sensitive vulnerability

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[3] It plays an essential role in the nervous system by supporting myelin synthesis and is critical for the maturation of red blood cells in the bone marrow