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4-HNE can also bind to nuclear hormone receptors, such as peroxisome proliferator-activated receptor delta (PPAR), promoting the transcription of genes involved in keratinocyte differentiation, such as involucrin and transglutaminase 1, thereby exacerbating epidermal hyperplasia typical of psoriasis [43]

This protection, although also well documented, is not absolute in IGHD, GHD associated with multiple pituitary defects and GHRH receptor deficiency (Shevah and Laron, 2007

Interestingly, when they used users of sulphonylureas as the comparator, GLP1-RAs users had a significant elevation in risk of thyroid cancer (weighted HR 1.80, 95% CI 1.282.52)