The literature reports that the insulin resistance induced by obesity with associated hyperinsulinaemia could promote cardiac remodelling via the growth-promoting properties of insulin or by attenuating the anti-apoptotic signalling of the phosphatidylinositol 3'-kinase (PI3K)- Akt (protein kinase B [PKB]) pathway elicited by insulin receptor activation [59,61]. This evidence concerns the gene INSR and obesity due to melanocortin 4 receptor deficiency.