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Mitochondrial Ca 2+ overload due to MCU overactivation increases Ca 2+ sensitivity, enhancing myosin light chain phosphorylation and promoting contraction, and mitochondrial ROS activate redox-sensitive pathways such as MAPK and NF-B, driving VSMC proliferation and neointima formation

Beta-hydroxybutyrate, a marker of fatty acid oxidation, increased by 78% to 181%, confirming that retatrutide drives substantial fat burning at the cellular level