IR can instigate an upsurge of inflammatory cytokines associated with obesity, including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, tumor necrosis factor-α, and interferon, which have been robustly linked to the development of PAH [48, 49]. The gene discussed is TNF; the disease is obesity due to melanocortin 4 receptor deficiency.