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Another large cohort study on the association of plasma metabolites with the risk of ESRD progression in T2DM patients found that tryptophan and kynurenine were involved in the risk of renal progression in T2DM patients, with tryptophan negatively associated with ESRD risk and kynurenine-to-tryptophan ratio positively associated with ESRD risk, with hazard ratios adjusted for clinical risk factors of 0.62, respectively (95% CI: 0.51, 0.75) and 1.48 (95% CI: 1.20, 1.84) per 1 SD 49

Receptor binding activates adenylyl cyclase, increasing intracellular cAMP and triggering calcium-dependent GH exocytosis

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