TNF and obesity due to melanocortin 4 receptor deficiency: Obesity, for example, is characterized by a state of chronic inflammation, where adipose tissue releases pro-inflammatory cytokines (TNF-α, IL-6), which promote insulin resistance and atherosclerosis, both contributing to CKM syndrome.[31,32] Furthermore, excessive oxidative stress can damage hepatocytes and disrupt vascular endothelial function, exacerbating the risk of metabolic and cardiovascular diseases.[33,34]