INS and obesity due to melanocortin 4 receptor deficiency: Leptin is one of the adipokines, and the blood concentration of leptin reflects the amount of adipose tissue.[23] Leptin is a critical contributor to obesity-related hypertension through increasing of sympathetic nerve activity.[24] Other than these mechanisms, insulin resistance, other adipokines, and inflammatory response associated with IAF accumulation are thought to be involved.[25]