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this is considered the most likely primary contributor Possible natriuretic effects linked to GLP-1 receptor activation, which may promote renal sodium excretion observed with other GLP-1 receptor agonists but not yet directly demonstrated for retatrutide in humans [4] Potential improvements in endothelial function associated with reduced systemic inflammation and insulin resistance again, a hypothesis extrapolated from the wider drug class Glucagon receptor activity , which may influence cardiac output and vascular tone