CTF1 and obesity due to melanocortin 4 receptor deficiency: Natal et al. found that cardiotrophin-1 levels were higher in subjects with metabolic syndrome than the control group10, and those who met the hyperglycemia criteria (fasting glucose > 100 mg/dl) or the obesity criteria (BMI > 30 kg/m2) had higher cardiotrophin-1 levels than those who did not.