TNF and obesity due to melanocortin 4 receptor deficiency: It is evidenced that smoking, hypertension, high saturated-fat diet consumption, hyperglycemia, obesity, or insulin resistance could induce the expression of a range of cytokines including TNF-α, TNF-β, IL-1α, IL-1β, IL-6, and certain messenger cytokines, such as macrophage colony stimulating factor (M-CSE), MCP-1, IL-18, and vascular cell adhesion molecule-1 (VCAM-1), by ECs.