INS and obesity due to melanocortin 4 receptor deficiency: Nevertheless, the results of the present study suggest that there are significant differences in the expression of various genes concerned with carbohydrate, lipid, and protein metabolism, ubiquitin mediated proteolysis, signal transduction pathways, neuroactive ligand-receptor interaction, nervous system pathways, cell adhesion molecules, cytokine-cytokine receptor interaction, insulin signaling and immune system pathways, oxidative phosphorylation, and PPAR signaling pathways in subjects with obesity and type 2 diabetes compared to normal.