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, accompanied by an increase in inflammatory markers such as interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) ( 58 ). Both IL-6 and TNF-α can induce endothelial dysfunction and exacerbate arteriosclerosis by increasing ICAM-1 and VCAM-1 expression ( 59
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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