INS and metabolic syndrome: It has been also reported that TNF-α antagonist etanercept administration fails to improve insulin sensitivity in patients with metabolic syndromes [173], which might be explained by the compensatory role of other cytokines in the absence of TNF-α since various other proinflammatory cytokines, such as IL-1, and IL-6 secreted by AT, are involved in the disruption of insulin signaling [174].