TNF and obesity due to melanocortin 4 receptor deficiency: The pathogenesis of ASCVD is considered to be multifactorial, involving oxidative stress and an upregulation of CAMs expression, induced by proinflammatory cytokines, including interleukin (IL)-6, tumor necrosis factor (TNF)- α, and IL-1 β, all of which are consequences of overweight/obesity, HCL, and related risk factors, including smoking and alcohol consumption (Boehme, Esenwa & Elkind, 2017; Nepal, Yadav & Kong, 2019).