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For instance, when intra-portal insulin levels are increased [e.g., obesity, Cushings syndrome or due to treatment with glucocorticoids and glucagon-like peptide-1 receptor agonists (GLP-1RA)] or decreased (e.g., anorexia nervosa and T1D) in disease states, these secondary changes (secondary association) alters hepatic GH sensitivity resulting in discordant GH and IGF-I levels (high GH/low IGF-I levels and low GH/high IGF-I levels, respectively)

10.1016/j.plefa.2021.102366

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Arch Toxicol Suppl 17:209214 Townsend DM, Tew KD, Tapiero H (2003) The importance of glutathione in human disease