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GPx4 also affects metabolic diseases, such as NAFLD (non-alcoholic fatty liver disease), where cGPx4 protein expression is down-regulated and induces the non-classical transcriptional variant iGPx4, which promotes ferroptosis by interacting with cGPx4 and converting it from an active monomer to an inactive oligomer, and OSA (obstructive sleep apnea), where macrophage-secreted IL6 promotes hepatocyte MARCH3 expression, mediates GPx4 ubiquitination degradation and exacerbates ferroptosis and lipid accumulation

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