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Lancet Oncol 16(5):499508 Zhu AX et al (2019) Ramucirumab after sorafenib in patients with advanced hepatocellular carcinoma and increased alpha-fetoprotein concentrations (REACH-2): a randomised, double-blind, placebo-controlled, phase 3 trial

Beyond simple biomechanics, where each 1 kg of weight gain multiplies knee joint load by 34 kg, accelerating cartilage wear and activating pathogenic pathways like Wnt/ -catenin, the endocrine function of fat is paramount (14, 15)