TNF and obesity due to melanocortin 4 receptor deficiency: In recent years, chronic consumption of fructose has been associated with cardiometabolic damage, such as obesity and dyslipidemia (3), and also with increases in the levels of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-6, and the generation of reactive oxygen species (ROS), which contribute to diabetic cardiomyopathy (4).