TNF-α secreted by M1 pro-inflammatory adipose tissue macrophages is one of the most important pro-inflammatory mediators in various organs of human body and could initiate the NF-κB and JNK pathways involved in the insulin resistance and the apoptosis of the β cells within the pancreatic islets36–41, which suggested TNF-α may play a central role in the development of MS. This evidence concerns the gene NFKB1 and myeloid sarcoma.