TNF and obesity due to melanocortin 4 receptor deficiency: Some studies have reported its possible effects on obesity and metabolic syndrome.5,6The expression of ZAG is regulated by TNF-alpha and PPAR-γ; thus, it may participate in lipid metabolism, enhance energy expenditure and skeletal muscle glucose transporters, inhibit of enzymes in lipogenesis pathways and stimulate adiponectin hormone expression.30 In this study, there were no significant differences between the two groups.