While slower than at 37 C, metabolism at 4 C favors the intracellular acidification, in turn inhibiting pH-sensitive enzymes at rate-limiting steps of glycolysis, the Rapoport-Luebering shunt, and the pentose phosphate pathway (PPP) 11,12
In HFD-fed ApoE / mice, however, Ach (10 7 mol/L) stimulation decreased the vascular tension to 68% in control group, 72% in metformin group and 69% in liraglutide group respectively, suggesting that monotherapy with either metformin or liraglutide did not improve vascular reactivity obviously
For adjacent comparisons, see Ro vs Noom (the behavioral coaching angle) and our broader best GLP-1 program ranking for nine providers scored by situation
A 2021 paper in Cephalalgia (Schievink et al.) described the same mechanism in spontaneous CSF leaks, where low CSF volume makes patients headache-free lying down but symptomatic upright