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These combined mechanisms underpin their efficacy for both weight reduction and cardiometabolic protection ( In recent years, the remarkable efficacy of tirzepatide, a dual GIP/GLP-1 receptor agonist, has emerged ( However, these benefits are accompanied by concerns about side effects, cost, long-term sustainability and, above all, the loss of lean mass, which may be mitigated by concurrent exercise ( Exercise and lifestyle interventions remain foundational for obesity and metabolic disease management, offering broad health benefits, but are often limited by adherence and modest long-term weight loss ( Recent randomized controlled trials and meta-analyses suggest that combining GLP-1RAs with exercise may yield additive or synergistic effects on weight loss and metabolic syndrome severity as well as on oxidative stress and inflammation

These degenerative tears are not symptomatic in the vast majority of individuals

Liver function markers (ALT, TBIL, AST, ALB), fibrosis markers (HA, PC III, LN), and liver fibrosis grades were assessed pre-and post-treatment

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