Dysregulation of PVAT as a consequence of obesity leads to dysregulated production of adipokines and cytokines such as decreased hydrogen sulphide, NO, and adiponectin and increased leptin, IL-6, TNF-α, IL-12, hydrogen peroxide, and the renin–angiotensin–aldosterone system [9,26]. The gene discussed is TNF; the disease is obesity due to melanocortin 4 receptor deficiency.