Several recent reports suggest that obesity, as indexed by elevated body mass index (BMI), may also affect NT-proBNP levels, with lower circulating levels in those with higher BMI in subjects with acute or chronic heart failure [2], [3], significant coronary artery disease or acute myocardial infarction [4], [5] and healthy general populations [6]. Here, NPPB is linked to obesity due to melanocortin 4 receptor deficiency.