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Following bariatric surgery, particularly Roux-en-Y gastric bypass, rapid nutrient delivery to the distal small intestine triggers markedly elevated GLP-1 secretionoften several-fold higher than pre-operative levels

Preclinical studies showed that exendin-4, a GLP-1R agonist derived from the saliva of the Gila monster, was able to significantly reduce the hepatic accumulation of triglycerides both in mouse models [82] and in human hepatocytes [83] by activating the signaling cascade downstream of the insulin receptor (see below)

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