TNF and hyperinsulinism: WAT also releases proinflammatory cytokine tumor necrosis factor (TNF)-α, which influences hyperinsulinemia in obesity, and proinflammatory cytokine interleukin (IL)-6, which produces free fatty acids (FFAs), causing poor glucose and liver metabolism (Hotamisligil et al. 1995; Luan et al. 2023; Wueest and Konrad 2018).