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Carney complex is an autosomal dominant hereditary tumor syndrome that includes cardiac myxomas, skin pigmentation, blue nevi, adenomas of the adrenal glands, testicles, and pituitary gland in addition to multiple MMNST (up to 20% of cases) [44]

Data availability The raw 16 S rRNA sequencing data used to produce all figures are accessible at the NCBI Short Read Archive under the following accession numbers: BioProject: PRJNA661156 and SRA: SRS7316558, SRS7317051, and SRS7315455

*Correspondence: Shimaa M

Chronic stress one of the most consistently cited contributors, with supporting research linking stress directly to altered gut-barrier function

Moreover, studies have shown that GLP-1RA could regulate glucose homeostasis in an insulin-independent mechanism via the 5-AMP-activated protein kinase (AMPK) pathway (36, 37)