HSD11B1 and obesity due to melanocortin 4 receptor deficiency: Additionally, since polymorphic variants of HSD11B1 that change its expression and activity are expected to have a major role in modulating insulin sensitivity and adipose tissue proliferation through regulation of intra-adipocyte cortisol production, the presence of these polymorphic variants would be expected to be associated with obesity as well, which was not demonstrated in the present review [35].