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In this regard, the adipose-liver axis is of particular importance, as excessive lipid flux, inflammatory mediators, and systemic insulin resistance resulting from adipose tissue dysfunction directly contribute to hepatic steatosis and metabolic damage ( Taken together, ADMSC-mediated regulation in obesity is best understood across three interconnected levels—autocrine regulation, paracrine interactions within the adipose niche, and endocrine interactions with distal tissues—which together link local adipose remodeling to broader systemic metabolic outcomes