The elevated CRP and reduced hemoglobin levels further indicate a vicious cycle between chronic inflammation and metabolic dysregulation: pro-inflammatory cytokines (e.g., IL-6, TNF-α) exacerbate malnutrition through muscle catabolism and appetite suppression (12), while malnutrition impairs immunomodulatory capacity, perpetuating inflammatory responses. Here, TNF is linked to malnutrition.