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The GLP1R gene encodes the very receptor semaglutide activates, while FTO , MC4R , and TCF7L2 influence fat mass, satiety, and glucose regulation

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Lower thresholds apply for people with recent-onset type 2 diabetes (BMI 30 kg/m) and for people of Asian family origin (typically 2.5 kg/m lower)

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These factors are considered key determinants driving the transition from hepatic steatosis to steatohepatitis and, in severe cases, to fibrosis and cirrhosis