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are elevated in various metabolic diseases, such as obesity, insulin resistance, and type 2 diabetes mellitus ( 67 , 68 ). In addition, serum concentrations of FGF21, soluble α-klotho, and interleukin 6 are significantly higher in male smokers
Developmental Endocrinology Research Group, University of Glasgow, Glasgow, UK
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Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
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Centre for Endocrinology, William Harvey Research Institute, Barts and The London Medical School, Queen Mary University of London, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
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Department of Paediatric Endocrinology, Makarios Children's Hospital, Nicosia, Cyprus
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Sussex Community NHS Trust, Brighton, UK
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The University of Dublin, Trinity College Dublin, Dublin, Republic of Ireland
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excessive weight gain, starting GH therapy may not be appropriate, especially in the presence of untreated or poorly managed OSA, poorly controlled type 2 diabetes mellitus (T2DM) and hypertension, and obesity-related complications. Once these complications