Chronic low-grade inflammation contributes to insulin resistance and β-cell dysfunction, and inflammatory cytokines such as Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) may be more proximal mediators than hs-CRP, which is a downstream acute-phase reactant and may be less sensitive to subtle pathway changes in relatively young or community-based samples [23, 24]. Here, TNF is linked to Insulin resistance.