TNF and obesity due to melanocortin 4 receptor deficiency: Adipocytokines released during chronic low-grade inflammation of the adipose tissue, in the context of obesity, have been directly linked to insulin-resistance and onset of MS and, subsequently, systemic dysfunction and DM.(11) Special attention is given to tumor necrosis factor-alpha (TNF-α), resistin and interleukin-6 (IL-6) as immunoinflammatory mediators that promote insulin-resistance.