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Pandey A et al
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For context, in a previous Phase 3 trial of Zepbound, the highest-dose group saw a dropout rate of only 6.2% due to adverse events
![tirzepatide hepatic impairment child-pugh [4005] Rating Scales for Dysfunction Drug treatment for metabolic dysfunction-associated](https://media.springernature.com/w215h120/springer-static/image/art%3A10.1007%2Fs12325-023-02536-8/MediaObjects/12325_2023_2536_Fig1_HTML.png)
This decline is a direct result of the entrance of more effective agents including Wegovy (semaglutide), approved in 2021, and Zepbound (tirzepatide), approved in 2023
![tirzepatide hepatic impairment child-pugh [4005] Rating Scales for Dysfunction Drug treatment for metabolic dysfunction-associated](https://www.frontiersin.org/api/ipx/w=1200&f=png/https://www.frontiersin.org/files/Articles/1753393/fendo-16-1753393-HTML/image_m/fendo-16-1753393-g001.jpg)
Their expression is induced by metals via multiple metal-responsive elements (MREs) present in the metallothionein gene 5-regulatory regions
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Given that carnitine concentrations are typically low, methods using GC-FID are less common
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