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RNA-seq and experimental results revealed that hepatic Serpina3c expression was consistently reduced in PPE offspring before and after birth, which led to an increase in chymase-Ang II production and subsequent activation of its receptor AT1R, leading to MASLD susceptibility

Practical takeaway Until stronger evidence exists, the review argues the path forward is collaborative pregnancy registries + better real-world data, so inadvertent exposures can be counselled with confidenceand so we can finally test whether pharmacotherapy could ever play a role in carefully selected high-risk cases

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Results Korean participants (n=110) showed a greater reduction in HbA1c and body weight with semaglutide 0.5 mg (1.6%, 2.7 kg) and 1.0 mg (1.8%, 4.8 kg) versus sitagliptin (0.9%, 0.5 kg)