Study of TNF-Antagonism in Metabolic Syndrome

Inclusion Criteria: Inclusion Criteria based on a modified WHO definition of metabolic syndrome 1. Hyperinsulinemia in the upper quartile of the non-diabetic population defined as \>= 10 mU/mL (Framingham Data, oral communication,James Meigs, MD) or fasting glucose 110-126 mg/dL Plus two of the following: 2. Abdominal obesity defined by waist hip ratio \> 0.90 for men and \> 0.85 for women or BMI \> 30 kg/m2 3. Dyslipidemia including serum triglycerides ³ 150 mg/dl or serum HDL \< 0.9 mmol/L for men (35 mg/dL) and \< 1.0 mmol/L (39mg/dL) for women 4. Hypertension defined as blood pressure \>= 140/90 or on medication Exclusion Criteria: 1. Positive PPD (³ 5mm induration) on screening 2. Current Infection 3. Therapy with glucocorticoid or immunosuppressant at time of recruitment or within past 3 months 4. Reception of live vaccine within 1 week of recruitment 5. History of blood dyscrasia including any kind of anemia, thrombocytopenia, pancytopenia. Women with a reversible cause of anemia that has resolved will be eligible. 6. History of malignancy (except patients with surgically cured basal cell or squamous cell skin cancers who will be eligible) 7. History of organ transplantation 8. History of CNS demyelinating disorder or any first degree relative with multiple sclerosis 9. History of CHF classes I-IV 10. Current use of insulin, any oral anti-hyperglycemic agents, pentoxyfylline, beta-agonists 11. Current use of fibrate or niacin 12. Initiation of statin therapy within prior 6 weeks or expecting a change in statin dose over the upcoming 3 months 13. Hemoglobin \< 11 g/dl 14. Positive pregnancy test 15. Women of child-bearing potential not currently using non-hormonal birth control methods including barrier methods (IUD, condoms, diaphragms) or abstinence 16. Patients with known autoimmune or inflammatory conditions (excluding patients with stable, treated hypothyroidism)