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The impaired mitochondrial FAO leads to insufficient supply of ATP, but also results in lipotoxicity, which together contribute to renal fibrosis (Lv et al., 2019

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This is also supported by previous studies, whereby Gly2Ala in exendin-4 was tolerated, but the converse for GLP-1 (Ala2Gly) reduced affinity 31,32,33