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Furthermore, PPAR- can reduce the expression of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), low density lipoprotein receptor (LDLR), and cytochrome P450 family 7 subfamily A polypeptide 1 (CYP7A1) via both dependent and independent pathways, disrupting the balance of cholesterol metabolism [78]

However, peptides have intrinsic weak points, and they did not provide encouraging results in vivo , likely due to their physical, chemical and structural instability and low membrane permeability (112, 119, 121)

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It is characterized by multi-factorial polygenic inheritance, incomplete penetrance, and multiple susceptibility loci (Shen et al., 2016)

Regular check-ins with your prescribing physician are important to evaluate results and decide whether to continue, adjust, or stop