TNF and obesity due to melanocortin 4 receptor deficiency: After adjusting for sex, age, hypertension, blood lipid concentration, and obesity, the analysis of covariance revealed that the levels of IL-10, IL-4, and TNF-α in the case group were significantly higher than those in the control group (P < 0.001, P = 0.011, and P < 0.001, respectively) (Table 3).