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However, the massive accumulation of fat in adipose tissue associated with obesity leads to dysfunctional adipocytes, with abnormal release of adipokines [41], including inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-6, plasminogen activator inhibitor 1, resistin, and monocyte chemoattractant protein 1 (MCP-1), which impair adipocyte responsiveness to insulin [18, 42]
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