Kloting et al. [41] confirmed this independent association when they showed that in two groups with an equally severe degree of obesity (BMI 45.0 ± 1.3 kg/m2), those with insulin resistance had pronounced macrophage infiltration of visceral adipose tissue and elevated serum CRP and reduced serum adiponectin concentrations; a higher serum IL-6 level in the insulin resistant group did not reach statistical significance (p = 0.08). Here, IL6 is linked to obesity due to melanocortin 4 receptor deficiency.