POSTN and obesity due to melanocortin 4 receptor deficiency: In addition, despite it has been well documented that obesity cause insulin resistance, which is involved in the pathogenesis of NAFLD, here we found that the participants with a 1-SD increase in circulating periostin showed a 1.75 times risk for NAFLD, no matter the degree of insulin resistance, indicating that alone an increased periostin concentrations could augment the NAFLD phenotype by the mechanisms differ from insulin resistance.