Our study also had the following limitations: the possible complex effect of other underlying diseases (and medications used for other diseases) on HMW adiponectin levels could not be excluded; our metabolically healthy obese subgroup was very small; the metabolically healthy obese phenotype definitions have not been standardized; and BMI as a measure of obesity has limitations because it cannot distinguish between fat tissue and lean tissue. Here, ADIPOQ is linked to obesity due to melanocortin 4 receptor deficiency.