Our results also provided the first evidence that NDRG4 had significant modifying effect on the prognostic value of obesity that obesity could be a significant independent predictor of unfavorable disease-free and overall survival among patients with colorectal cancer of reduced NDRG4 expression, but not among those with preserved NDRG4. This evidence concerns the gene NDRG4 and obesity due to melanocortin 4 receptor deficiency.