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Furthermore, protease-activated receptor 2 (PAR2) signaling in melanocytes amplifies oxidative and inflammatory responses through the Akt/NF-B axis, elevating cytokine production and reducing antioxidant defenses, based on CAT and SOD activity, exacerbating skin inflammation 126

In line with this, sustained exposure to high GH levels induces both hepatic and peripheral (muscular) resistance to the actions of insulin on glucose metabolism together with increased (or inadequately suppressed) lipid oxidation

Because of its high prevalence in conjunction with obesity, diabetes, and insulin resistance, NAFLD has been increasingly appreciated as a hepatic manifestation of metabolic syndrome and is the leading cause of death from liver disease in the United States 1,2,3

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