TNF and sarcopenia: Sarcopenia occurs in 42% of IBD patients.66 The intestinal microbiota stimulates mucosal immune cells to promote pro-inflammatory cytokines (interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-α), etc.), produce the general state of chronic low-grade inflammation, activate oxidative stress injury, and further influence insulin sensitivity, amino acid biosynthesis, mitochondria, biological generation, the synthesis and catabolism of muscle and the increase muscle attenuation-related molecular pathways.