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© 2020 Federation of American Societies for Experimental Biology.The disproportionate obesity in African-American (AA) women has a physiologic basis, and can be explained by the interactive effects of insulin secretion, insulin clearance, insulin sensitivity, and the glycemic load of the diet. This review will present data supporting a physiologic basis for obesity propensity in obesity-prone AA women that resides in their unique metabolic/endocrine phenotype high beta-cell responsiveness, low hepatic insulin extraction, and relatively
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