TNF and obesity due to melanocortin 4 receptor deficiency: In a study of children aged 7 to 14 years, Codoner-Franch et al [5] classified children with obesity as metabolically healthy or at risk (defined as having at least 4 metabolic risk factors including abdominal adiposity, impaired glucose metabolism, low high-density lipoprotein [HDL] cholesterol, elevated triglycerides, and hypertension), and they reported that CRP, tumor necrosis factor α, and interleukin (IL) 6 were all increased in children with obesity regardless of metabolic risk factors.