TNF and obesity due to melanocortin 4 receptor deficiency: Obesity contributes to migraine pathogenesis through inflammatory factors (e.g., interleukin-6, tumor necrosis factor-α) secreted by adipocytes and vasoactive substances (e.g., calcitonin gene-related peptide).[22] However, BMI as a global marker of obesity cannot reflect visceral fat accumulation or specific phenotypes of metabolic syndrome.