TNF and obesity due to melanocortin 4 receptor deficiency: In this case, several pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) [6, 7] and interleukin-6 (IL-6) [8] that develop inflammation through the reactive oxygen species (ROS) generation and oxidative stress pathways, decisively induce IR in peripheral tissues and adipocytes, particularly in a case of obesity [9].