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Acknowledgments We thank our study volunteers for providing samples and supporting this work and the clinical staff for their dedication to this research

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Regul Pept 128:117124 Decombaz J, Deriaz O, Acheson K, Gmuender B, Jequier E (1993) Effect of l-carnitine on submaximal exercise metabolism after depletion of muscle glycogen

The efficacy of setmelanotide may not be sufficient for POMC-MC4R deficient patients because body weight reduction ratio of semaglutide and tirzepatide were 12.4 and 17.8%, respectively in clinical study as compared with that of setmelanotide, 5.2% [[18, 19, 23]]

Mechanism of Action: GHS-R1a Agonist Ipamorelin exerts its effects through selective agonism of the growth hormone secretagogue receptor type 1a (GHS-R1a) , also known as the ghrelin receptor