The synthesis of TNF-α in adipose tissue reflects the direct connection between TNF-α serum levels, obesity, and hyper-insulinemia.7 Also, it is considered that TNF-α can control a vital regulator like autoparacrine glands for the fat cell to scrutinize the expansion of adipose-tissue, possibly by the inducing mechanism of insulin resistance, which can further lead to metabolic syndrome.8 The present study’s objective was to determine the serum TNF-α concentrations in Saudi patients of MetS and the normal controls and to detect their relationship with different MetS components. This evidence concerns the gene TNF and obesity due to melanocortin 4 receptor deficiency.