TNF and Insulin resistance: Additionally, cellular metabolic processes could also be regulated by inflammatory molecules or inflammatory pathways, such as cytokines (tumor necrosis factor [TNF]-α, interleukin [IL]-6, and IL-1β), which could act in an autocrine or paracrine manner and interfere with the insulin signaling in peripheral tissues by activating the c-Jun N-terminal kinase (JNK) pathway or nuclear factor kappa B (NF-κB) pathway, inducing β-cell dysfunction and promoting insulin resistance (9, 10).