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Interplay between GLP-1 Signaling and Muscle Metabolism GLP-1RAs modulate metabolism through multiple intracellular signaling pathways, including cAMP/PKA, PI3K/Akt, and SIRT1-mediated cascades, influencing glucose uptake, mitochondrial function, and inflammatory responses [82], which may contribute to interactions between GLP-1RA therapy and skeletal muscle metabolism, potentially affecting muscle metabolism and quality

Tirzepatide works by mimicking two metabolic hormones in the body: it acts as a glucagon-like peptide-1 (GLP-1) receptor agonist and also as a glucose dependent insulinotropic polypeptide (GIP) receptor agonist

However, it suggested that a ureido residue with its side chain shifted to the second backbone methylene (i.e

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