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A good example is the finding that low circulating levels of IGF-1 are independently associated with hyperglycaemia and insulin resistance in adults [160, 230232]

Thus, high total IGF-I levels in CKD is inadequate in suppressing the increased GH levels because of the lower IGF-I bioactivity resulting in the lack of IGF-I feedback on pituitary GH secretion (75, 77) ( Table 1

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Annals of the New York Academy of Sciences, 1270, 6672