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Upon GLP-1 binding to its receptor GLP1R on pancreatic beta cells, a signaling cascade is initiated, leading to the activation of adenylyl cyclase and the production of cAMP), which activates protein kinase A (PKA) enhancing insulin gene transcription and insulin secretion 81

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Notably, only one hGM group (O15) acquired the TMA/TMAO-producing ability from its donor, whereas the other three hGM groups had undetectable plasma d9-TMA and d9-TMAO (Fig