TNF and Other metabolic disease: Notably, systematic evaluations of inflammatory biomarkers in PCOS (e.g., CRP, IL-6, TNF-α) show consistent elevations compared with controls (10); mechanistic overviews and cohort analyses in overweight PCOS further delineate mitochondrial dysfunction, altered adipokine signaling, and hepatic insulin resistance as central features of the metabolic disorder (11, 12).