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High concentrations of GH and subsequent insulin-like growth factor-1 (IGF-1) can adversely affect insulin sensitivity and stimulate unwanted pathways associated with cell proliferation

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5,6 In addition, receptor activator of nuclear factor kappa beta ligand (RANKL), that plays a crucial role in osteoclast activity and bone resorption, 21 also directly influences pancreatic beta-cell function and overall metabolism, with its activity being compromised in obesity and T2D