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In obese individuals with hyperinsulinemia, hepatic GHR expression is enhanced as indicated by elevated GHBP levels reflecting proteolytic cleavage of highly expressed surface GHR and release of the extracellular part to the circulation (65)

This is a fundamental limitation of the enterprise: the arithmetic is exact, but its inputs are uncertain, so an exact calculation on an uncertain input yields an uncertain result dressed up in false precision

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Obesity contributes to the onset and progression of OSAS through multiple mechanisms