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The following were measured alongside HOMA indices: Lipid profile, cardiac enzymes, leptin, insulin, TMAO and LPS levels

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Observed Heart Rate Changes: Increase of 5-10 beats per minute during treatment Peak increase around week 24, then gradual decline Persists but diminishes through week 68 Why This Happens: Sympathetic nervous system activation Increased metabolic rate from weight loss Direct effects on cardiac tissue Clinical Significance: Modest heart rate increases (5-10 bpm) don't appear harmful in clinical trials

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