TNF and endothelial dysfunction: Sinatora et al. (2022) reported altered inflammatory cytokine ratios, notably a significantly increased IL-10/TNF-α ratio, indicating immune imbalance and endothelial stress, while Klisic et al. (2023) observed significantly elevated circulating levels of endocan and C-reactive protein (CRP) in women with metabolic syndrome, consistent with subclinical endothelial dysfunction [20,21].