High levels of numerous inflammatory cytokines, including interleukin (IL)-1α, IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, and tumor necrosis factor (TNF)-α, have been reported in patients with SD.[3] Further, increased levels of inflammatory markers, along with an elevated frequency of metabolic syndrome and osteoporosis, suggest the presence of subclinical systemic inflammation in patients with SD.[4–9]. This evidence concerns the gene TNF and metabolic syndrome.