TNF and Hyperinsulinemia: However, both ectopic fat accumulation and adipose tissue expansion stimulate the secretion of pro-inflammatory adipokines such as leptin, interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) and inhibit the release of anti-inflammatory products such as adiponectin, thus modifying metabolic and inflammatory processes, and triggering metabolic changes such as hypertension, hyperinsulinemia, dyslipidemia, diabetes, and other conditions (6).