Furthermore, higher VAT is associated with adipocyte hypertrophy, known to be linked with increased insulin resistance, cellular stress and consequent necrosis followed by macrophage recruitment and increased inflammation with the releasing of pro-inflammatory cytokines such as tumor-necrosis-factor alpha (TNFα) and interleukin-6 (IL-6) that contribute to low-grade chronic inflammation and joint obesity-related CV and metabolic complications (10). The gene discussed is TNF; the disease is Insulin resistance.