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This is significant because age-related sleep disruption often involves not just melatonin deficiency but broader circadian gene dysfunction

Yamamoto Y, Mochida J, Sakai D, Nakai T, Nishimura K, Kawada H, Hotta T: Upregulation of the viability of nucleus pulposus cells by bone marrow-derived stromal cells: significance of direct cell-to-cell contact in coculture system

Providers should monitor weight trajectory , GI tolerability (nausea, vomiting, constipation) , signs of pancreatitis (persistent severe abdominal pain vomiting), gallbladder disease (RUQ pain, fever, jaundice), hydration/renal function when clinically indicated (risk of AKI with severe GI effects), blood pressure , and glucose metrics (especially if combined with insulin or sulfonylureas due to hypoglycemia risk)