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Unfortunately, diagnostic accuracy of TNF was only assessed in blood and yielded low specificity and sensitivity, which is unsurprising in light of the discrepancies across studies

Trist et al

It should be clarified that although the contribution of immune cells to metabolic diseases is mainly concentrated in AT, an effective source of such inflammation also exists in the liver, intestines, and other metabolic regulatory tissues, promoting the production of inflammation and obesity throughout the body through the circulation (131)

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