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Based on this combined evidence, gastrointestinal side effects tend to follow a broadly predictable temporal pattern

Wishart TFL, Flokis M, Shu DY, Das SJ, Lovicu FJ

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[78] found that Lira inhibited proprotein convertase subtilisin/kexin type 9 (PCSK9) expression in HepG2 cells and db/db mice through hepatocyte nuclear factor 1 (HNF1)-dependent mechanism, and may inhibit LDLR expression in db/db mice through PCSK9 independent pathway, and ultimately reduce liver cholesterol accumulation