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Under hypothermic hypoxic conditions, cell swelling is attributed to altered intra- and extracellular ion concentrations (driven by the Na + /H + exchanger, Na + / symporter, and Na + -K + -2Cl cotransporter), reduced levels of cyclic adenosine monophosphate, decreased Na + /K + -ATPase activity, and upregulated expression of nuclear respiratory factor 1, ultimately resulting in inadequate organ perfusion (86, 106108)
This is an area where future research will be critically important
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The improvements in insulin sensitivity attributed to tirzepatide were only partly explained by weight loss, suggesting that the dual receptor agonism of tirzepatide provides distinct mechanisms for glycemic control beyond weight reduction
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