TNF and metabolic syndrome: It is closely linked to metabolic syndrome (MS), where obesity, dyslipidemia, and hypertension amplify IR through: proinflammatory cytokine release (e.g., TNF-α, IL-6), ectopic lipid accumulation (hepatic and muscular lipotoxicity), oxidative stress-mediated inhibition of insulin receptor signaling (e.g., PI3K/Akt pathway) (9).