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The consequences of histone lysine -hydroxybutyrylation are changes in expression of numerous genes such as the gene for the transcriptional co-activator, PGC-1 (encoded by the PPARGC1B gene) which is itself involved in the regulation of expression of numerous genes involved in energy homeostasis, the insulin receptor substrate 2 (IRS2) gene whose encoded protein is involved in insulin signaling, and the carnitine palmitoyltransferase 1A (CPT1) gene whose encoded protein regulates the ability of the mitochondria to oxidize fatty acids
LC revised the manuscript
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Some patients report feeling slightly more energetic after the switch, possibly related to tirzepatides more pronounced effects on glucose stability
