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Obesity-associated adipose tissue thus functions as an inflammatory endocrine organ, particularly in visceral tissue producing TNF-α, IL-6, IL-1β, Monocyte chemoattractant Protein 1 (MCP-1, which is associated with tamoxifen resistance), and leptin while reducing adiponectin (an anti-inflammatory adipokine) levels, thereby promoting chronic low-grade inflammation, insulin resistance, and tumor-promoting signaling pathways

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