TNF and Insulin resistance: Indeed, obesity appears to be a major environmental factor contributing to the onset and progression of autoimmune diseases29 and is independently associated with inflammation markers in lupus patients.30 Adipose tissue secretes cytokines such as TNF-α, IL-6, and IL-1031 known to be involved in both SLE32 and atherosclerosis.33 Furthermore, BMI has been associated to increased serum level of dysfunctional pro-inflammatory HDL and free fatty acids, and to insulin resistance in patients with SLE,34–36 all known to contribute to atherosclerosis.