Taken together, these evidence support the notion that, in obesity and metabolic syndrome, the elevated levels of TNF-α, and possibly IL-6, may increase the chance of destructive periodontal diseases development, which could be directly through mechanisms discussed earlier and also indirectly by enhancing the bacterial-induced host immune response in obesity and metabolic syndrome. This evidence concerns the gene IL6 and obesity due to melanocortin 4 receptor deficiency.