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A ratio below 1 is typical of metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD)

Mechanistically, these agents bind the GLP-1 receptor, enhancing glucose-dependent insulin secretion, slowing gastric emptying, and modulating appetite centers

The result is usually worse bloating, more discomfort, and the mistaken conclusion that fiber supplements do not work for them

Another study in colonic-sensitized rat models demonstrated that exendin-4 treatment dose-dependently reduced visceral hypersensitivity by upregulating serotonin transporter (SERT) expression and downregulating tryptophan hydroxylase-1 (TPH-1) expression [57]