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Its core pathological feature is excessive accumulation of adipose tissue, accompanied by abnormal proliferation, differentiation, and metabolic dysfunction of adipocytes, which in turn induce a series of complications including insulin resistance, nonalcoholic fatty liver disease, and cardiovascular diseases

Free T4 (FT4) levels tend to be normal or slightly reduced [62], while total T4 may be raised [63] or unaltered [64, 65]

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These effects are uncomfortable but self-limiting and resolve within 24 hours with rest and hydration