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Metabolic signals such as ghrelin, insulin or glucagon modulate insulin sensitivity, glucose tolerance, lipid metabolism, vascular hemostasis, and even immune responses 120,121

Moscatello, M.C

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This pharmacologic gastroparesis can unpredictably delay absorption of other orally administered drugs, potentially altering expected toxicokinetics

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This aligns with the body-first PD subtype theory, suggesting that peripheral initiation may precede CNS involvement (Goedert et al., 2017