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Excess adiposity is associated with insulin resistance, compensatory hyperinsulinemia, increased inflammation and increased production of adipokines including leptin. Insulin resistance also leads to upregulation of IGF1 and IGF2 production. Inflammatory cytokines, insulin, IGFs and leptin stimulate colorectal cancer cell proliferation, both via systemic as well as local paracrine pathways. Abdominal obesity is inversely associated with circulating adiponectin levels.
