TNF and hyperinsulinism: Skeletal muscle, responsible for 80% of postprandial glucose uptake, is highly insulin-sensitive; sarcopenia reduces muscle mass, impairs glucose utilization, and exacerbates insulin resistance with compensatory hyperinsulinemia [14].Visceral adipose tissue releases free fatty acids and proinflammatory cytokines tumor necrosis factor-α (TNF-α) and Interleukin-6 (IL-6), which disrupt phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway and activate ubiquitin–proteasome-mediated muscle proteolysis [15].