Insulin resistance leads to inflammation and increased oxidative stress19, obesity induces the secretion of pro-inflammatory cytokines such as leptin, interleukin-6 and tumor necrosis factor-alpha by adipose tissue20, resulting in glomerulosclerosis due to enhanced expression of intra-renal transforming growth factor-beta21. Here, TNF is linked to obesity due to melanocortin 4 receptor deficiency.