TNF and Hyperglycemia: Several studies have showed that the significantly down-regulated miR-146a induced by longstanding hyperglycemia not only causes the overexpression of pro-inflammatory factors (IL-6, TNF-α and IL-1β) and NF-κB (101–103) but also generates excess ROS via NADPH oxidase 4 pathway, which impairs the diabetic cardiovascular system (101).