TNF and Insulin resistance: No doubt visceral adipose tissue plays a key role in the development of insulin resistance, inflammation, and NAFLD, possibly through the secretion of multiple factors, such as the increased release of nonesterified fatty acids, increased production of various hormones, and proinflammatory adipocytokines (including TNF-α, IL-6, leptin, visfatin, and resistin) and decreased production of adiponectin.