TNF and neoplasm: Both tumor cells and host immune cells (such as macrophages and lymphocytes) release cytokines or hormones, such as IL-6, tumor necrosis factor α (TNF-α), zinc-α 2-glycoprotein (ZAG, also known as lipid mobilization factor), proliferin-1, catecholamines, and natriuretic peptide, which can promote lipolysis and reduce insulin sensitivity in CAC patients (6, 73, 80, 81).