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importantly, this effect was attenuated after adjusting for glycated hemoglobin (HbA1c) levels, suggesting a strong correlation with the degree of glycemic improvement [85]

Hepatology 68 , 15741588 (2018)

The accumulation of fibrillar collagensparticularly collagen type VI alpha 3 chain (COL6A3) and collagen Iis a hallmark of metabolically impaired adipose depots, and their crosslinking by lysyl oxidase (LOX) further increases ECM rigidity and mechanical stress on adipocytes [53]

Additionally, the severity and persistence of hiccups appear to vary widely among patients, indicating that individual physiological differences may play a role in susceptibility to this side effect

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