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Ultimately, the decision to use tirzepatide after gastric sleeve requires shared decision-making between patient and provider, weighing potential benefits against risks, costs, and the limited evidence base specific to this population

Both conditions frequently occur together in individuals with obesity, type 2 diabetes, insulin resistance, and unhealthy dietary patterns, which create a metabolic environment promoting both kidney stone formation and liver fat accumulation

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MALT1 hydrolase, located upstream of the Gln degradation pathway promoting GLS1-mediated Gln catabolism via c-Jun1, promoted epigenetic modification of H3K9Ac and H3K27Ac of the IL17A gene promoter, enhancing the chromatin accessibility of RORt (RORC), thus exacerbating IL-17A expression and ultimately causing immune peripheral blood imbalance and psoriatic lesions (79)