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Concurrently, HIF-1 upregulates the expression of LDH and pyruvate dehydrogenase kinase (PDK), promoting the conversion of pyruvate to lactate and inhibiting the entry of pyruvate into TCA cycle, further shifting energy metabolism toward glycolysis (Cai et al., 2020)

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Semaglutide activates the GLP-1 receptor (GLP-1R), a class B G-protein-coupled receptor expressed in pancreatic beta cells, the hypothalamic arcuate nucleus, the area postrema, the nucleus tractus solitarius, and vagal afferent neurons