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This dual activation leads to a more pronounced effect on blood sugar regulation and weight loss compared to medications that only target the GLP-1 receptor

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Jung D, Xu Y, Sun Z, Jung D, Xu Y, Sun Z (2017) Induction of anti-aging gene Klotho with a small chemical compound that demethylates CpG islands

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And then they looked at who was also on hormone replacement therapy, and that was either oral or transdermal estradiol, not vaginal estradiol