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When compared with placebo or other therapies, GLP-1 agonists were associated with an increased risk of biliary disease [23]: Overall biliary disease: RR 1.37(95% CI 1.231.52) Cholelithiasis: RR 1.27 (95% CI 1.101.47) Cholecystitis: RR 1.36 (95% CI 1.141.62) Mechanisms: Reduced gallbladder motility Rapid weight loss increased cholesterol saturation and gallstone formation

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While many of these genes are involved in general cellular processes, some play direct roles in antimicrobial defense

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Swaner JC, Connor WE: Hypercholesterolemia of total starvation: Its mechanism via tissue mobilization of cholesterol