TNF and obesity due to melanocortin 4 receptor deficiency: Differently, serum levels of TNF-α and IL-6 are increased only when the level of adiposity is very high, and are even higher in the presence of PCOS, suggesting that the role of obesity in the etiology of PCOS is mainly related to higher secretion of TNF-α and IL-6 adipocytokines by adipocytes, being little influenced by leptin and adiponectin in this population.