TNF and atherosclerosis: Metabolic syndrome is associated with enhanced atherosclerosis, insulin resistance, and obesity which occur due to chronic inflammation and endothelial dysfunction and also increase the risks of cardiovascular diseases and formation of abnormal adipocytokines including pro-inflammatory mediators interleukin-1 and 6 (IL-1, IL-6), tumor necrosis factor α (TNF-α), adiponectin, and leptin (McCracken et al., 2018).