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15 The SFRP2/DPP4 fibroblast subpopulation serves as the progenitor for fibrogenic fibroblasts in SSc skin, and DPP4-induced NF-kB and SMAD signaling via PAR2 activation leads to dermal fibroblast activation

In addition, because the studies participants had severe hyperglycaemia, metformins glucose-lowering effect may have also been related to changes in peripheral insulin sensitivity, but this was not measured in those studies

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Concurrent lifestyle interventionsregular exercise, sleep optimization, stress management, and adequate hydrationdirectly reduce anxiety and improve GLP-1 tolerability

More recently, metabolic cage studies have confirmed that the increased oxygen consumption and energy expenditure effect of OXM is mediated through glucagon receptor signalling (39, 40)

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