TNF and osteoporosis: These elevated MCP-1 levels are also associated with a decrease in bone mineral density and attenuated oestrogen concentrations, and positively associated with inflammatory markers tumour necrosis factor-α (TNFα), interleukin-6 (IL-6) and visual analogue scores, a pain assessment used with post-menopausal osteoporosis sufferers, potentially highlighting MCP-1 as a biomarker for reflecting post-menopausal osteoporosis disease severity [52].