However, some authors have reported proinflammatory action of APLN [104]: in a clinical study performed by Heinonen et al. patients with metabolic syndrome showed high level of APLN and TNF-α [105] while other studies revealed that APLN mitigates hepatic macrophage infiltration and TNF-α expression and reduces myocardial inflammation induced by diabetes condition or sepsis shock [106,107,108,109]. This evidence concerns the gene TNF and metabolic syndrome.