TNF and atherosclerosis: In the IR state, a high concentration of FFA can promote the activation of M1-type macrophages in the liver and promote the secretion of chemokines, such as CCL2 (MCP-1), TNF-α, CXCL8, CXCL2, and IL-6, which contribute to the development of atherosclerosis by regulating the activation of leukocytes, the development of foam cells and thrombosis, the proliferation of smooth muscle cells, cell egress from lesions, angiogenesis (49, 50), damage to endothelial cells and vessels (51) and the recruitment of an increasing number of monocytes and macrophages (52, 53).