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Tirzepatide acts on two specific receptors: GLP-1 and glucose-dependent insulinotropic polypeptide (GIP)

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As a consequence, proteins that should be modified by vitamin K are not, including proteins essential to blood clotting, and are thus not functional

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Furthermore, inhibition of SIRT1 promotes inflammatory reactions since SIRT1 inhibits transcription of nuclear factor kappa B (NF-B) which also inhibits SIRT1 activation via activation of microRNA and miR-34a which reduce NAD synthesis (Qian et al