TNF and Insulin resistance: Pro-inflammatory adipokines (IL-6, TNF-α, MCP-1) and leptin, associated with the maintenance of the obese state, are elevated during the obese state whereas adiponectin, which plays an important role in insulin sensitivity, is decreased, connecting its role to insulin resistance and T2DM (Friedman and Halaas, 1998; Sirico et al., 2018).