GH1 and obesity due to melanocortin 4 receptor deficiency: Our previous studies also confirmed the abnormalities of the GH/insulin-like growth factor 1 (IGF-1) axis in children with obesity [12], and the reduced GH and IGF-1 secretion were independently associated with cardiovascular risk factors such as metabolic syndrome [12], hyperuricemia [13], and nonalcoholic fatty liver disease (NAFLD) [14, 15].