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Ca 2+ levels are regulated (38) to balance disorders of cardiac calcium metabolism, inhibiting cardiac hypertrophy (39) and decreasing heart failure risk

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Various inflammatory pathways are subsequently activated, leading to the release of pro-inflammatory cytokines such as TNF-, IL-1, and IL-6, which contribute to the ongoing joint damage through the perpetuation of chronic synovial inflammation[18]

Disrupted sleep and chronically elevated cortisol are known upstream contributors that reduce L-cell sensitivity and dampen hormonal responsiveness

doi: 10.3389/fendo.2024.1309118

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