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GLP-1R is expressed in multiple cardiovascular cell types such as monocyte/macrophages, smooth muscle cells, endothelial cells, and cardiomyocytes

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Comprehensive evaluation should include complete thyroid panel (not just TSH), fasting insulin and HOMA-IR for insulin resistance assessment, cortisol testing for adrenal dysfunction, sex hormone panel (testosterone, estrogen, progesterone), sleep study if sleep apnea is suspected, medication review for weight-promoting drugs, and psychological evaluation for eating disorders or food addiction

A trial evaluating the broader physiological impacts of semaglutide, including effects on cardiovascular function, renal function and insulin sensitivity in adults, is currently active [52]