TNF and endothelial dysfunction: The median serum concentrations of inflammatory cytokines such as Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), and myeloperoxidase are significantly elevated, which can induce endothelial dysfunction, insulin resistance, dyslipidemia, and aberrant activation of the coagulation cascade, thereby accelerating atherosclerosis [10].