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This fatty acid chain binds non-covalently to serum albumin in the bloodstream, which: Protects the peptide from enzymatic degradation Creates a circulating reservoir the drug slowly releases from albumin into the free (active) form Slows renal clearance the albumin-drug complex is too large for kidney filtration Provides sustained release free retatrutide is continuously replenished from the albumin-bound pool DPP-4 Resistance An alpha-amino isobutyric acid (Aib) residue at position 2 makes retatrutide resistant to cleavage by the DPP-4 enzyme, which would otherwise degrade it within minutes

Int J Womens Health 2023;15:273287
