Compared with non-obese patients with PCOS, those with obesity demonstrated more severe inflammatory responses, including increased levels of IL-6, TNF-α, neutrophil-to-lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP), and mean platelet volume (MPV) levels [48, 49]. Here, TNF is linked to obesity due to melanocortin 4 receptor deficiency.