TNF and Insulin resistance: As TNF-α plays a central role in obesity-related insulin resistance, CCL2 is a key player in the development and maintenance of chronic adipose tissue inflammation and insulin resistance, and resistin is associated with insulin resistance, the IH-induced upregulation of these adipokines in adipocytes induces and/or worsens insulin resistance and/or type 2 diabetes in OSA patients (Figure 5).