DDIT3 and obesity due to melanocortin 4 receptor deficiency: It should be noted that the autophagic pathway, which can lead to non-apoptotic cell death by engulfing, degrading and recycling of cell organelles and proteins [34], is also associated with ER stress [35]; because in the present study, lipotoxic cell death associated with UPRs was assessed solely by determination of CHOP expression and caspase 3/7 activity, the possibility cannot be ruled out that other forms of cell death may also play a role in obesity-related macrophage phenotypic shifts.