Oxidative stress and specific markers of inflammation mediate, at least partly, the observed association between ATD and progression of Pre-DM since subjects with high-VAI values were found to have higher levels of C-reactive protein (CRP), interleukin-6 (IL‐6), tumor necrosis factor α (TNF‐α), serum amyloid‐A, homocysteine, and fibrinogen [51]. This evidence concerns the gene TNF and Jeune syndrome.