TNF and endothelial dysfunction: VAT is highly metabolically active and secretes a range of pro‐inflammatory cytokines and adipokines16, 17, 18, 19 such as tumor necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6) which lead to chronic systemic inflammation, endothelial dysfunction, and reduced nitric oxide (NO) bioavailability.