Some of thesecytokines, with pro-inflammatory characteristics that are increased in obesity, aredirectly associated with insulin resistance, such as leptin, TNF-α and visfatin, whileadiponectin, a cytokine with anti-inflammatory characteristics, is reduced in thepresence of obesity and is described as inversely associated with insulinresistance.21 The gene discussed is TNF; the disease is obesity due to melanocortin 4 receptor deficiency.