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When efferocytosis is impaired, and adipocyte apoptosis increases in morbid obesity, metabolic syndrome, and T2DM, apoptotic bodies undergo secondary necrosis, releasing DAMPs that amplify local inflammation and reinforce a self-sustaining loop between adipose remodeling, immune activation, and insulin resistance [967,968,969,970]

In a study of healthcare records in the Welsh population, Demmler et al

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