TNF and pulmonary fibrosis: Obesity results in insulin resistance, vitamin D deficiency, and increased expression of fibrogenic factors including TGF-β, and proinflammatory cytokines such as TNF-α and C-reactive protein; these changes cause pulmonary fibrosis (Wortsman et al., 2000; Ford et al., 2005; Botella-Carretero et al., 2007; Vimaleswaran et al., 2013; Han et al., 2021).