TNF and rheumatoid arthritis: However, chronic exposure to adverse metabolic and hemostatic risk factors (Masi et al., 2018), obesity (Engin, 2017), or disease states such as kidney disease (Rabelink et al., 2010) or rheumatoid arthritis (van Zonneveld et al., 2010) are all associated with a systemic inflammatory condition and elevated circulating levels of TNFα.