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Fig. 2. The vicious cycle between androgen excess and abdominal adiposity (blue arrows). Androgen excess of ovarian and/or adrenal origin is observed through the direct effects (gray arrow) of several autocrine, paracrine, and endocrine mediators (downregulation of adiponectin and upregulation of tumor necrosis factor [TNF], interleukin [IL]-6, and leptin) or indirectly through the induction of insulin resistance and hyperinsulinemia of abdominal visceral adiposity.17,18
J Obes Metab Syndr 2021;30:209~221 https://doi.org/10.7570/jomes21043