Taking together the findings that OLETF with metabolic syndrome had mild hyperglycemia but early endothelium dysfunction, while GK without metabolic syndrome showed higher blood glucose but enhanced vasodilation, it is suggested that the conventional risk factors, such as obesity, hyperinsulinemia, and dyslipidemia, rather than hyperglycemia, contribute to the increased cardiovascular events in type 2 diabetes. This evidence concerns the gene GK and obesity due to melanocortin 4 receptor deficiency.