TNF and obesity due to melanocortin 4 receptor deficiency: Plasma concentration of inflammatory mediators, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) are higher in obesity and patients with T2DM in which insulin resistance occurs.[7] Inflammatory markers stimulate endothelial production of adhesion molecules such as intercellular adhesion molecules (ICAMs), vascular cell adhesion molecule (VCAM), and endothelial-leukocyte adhesion molecule (E-selectin).