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Most people tolerate this combination without adverse effects

Factors such as inflammation, oxidative stress, hyperglycemia, hypoxia, toxins, and shear stress each play a significant role in altering ECs function and contributing to disease

The chronic disease risk the benefit was designed to reduce type 2 diabetes progression, cardiovascular events, and hypertension management costs remains in the population's risk profile

Conversely, some Firmicutes, including butyrate-producing species like Faecalibacterium, Roseburia, and Eubacterium, are known to enhance the function of enteroendocrine cells and maintain barrier integrity, which in turn has an indirect effect on GLP-1 secretion and neuroendocrine activity [130,131]

The SELECT trial (2023) demonstrated cardiovascular benefit over 5 years of treatment, supporting long-term safety in adults with obesity and established cardiovascular disease

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