Visceral adipose tissue is more metabolically active than subcutaneous fat, and produces adipokines, such as adiponectin and leptin, that can lead to proinflammatory, procoagulant, and insulin-resistant states, which may promote tumorigenesis in the local environment.(25) The importance of adipose tissue location in terms of the risk of metabolic dysfunction is evident because central obesity is more strongly associated with an increased risk of insulin resistance than BMI alone.(26,27). Here, LEP is linked to Insulin resistance.