In no previous study the increase in NT-proBNP was attributable to conditions that typically upregulate NT-proBNP secretion, such as elevated blood pressure, cardiac hypertrophy, increased left ventricular filling pressures or ventricular dysfunction, whereas evidence is emerging on the metabolic roles played by natriuretic peptides in obesity and diabetes development [13]. Here, NPPB is linked to obesity due to melanocortin 4 receptor deficiency.