Dhanasekaran et al.28 reported that insulin resistanceinduced by obesity with associated hyperinsulinemia could promote cardiacremodelling via the growth-promoting properties of insulin or by attenuating theanti-apoptotic signalling of the phosphatidylinositol 3' -kinase/protein kinase Bpathway.29 Studies in micewith (functional) leptin deficiency have suggested that the cardiac hypertrophydeveloping in states of chronic hyperleptinaemia may result from an inability totransduce anti-hypertrophic and/or cardioprotective effects of theadipokine.29 This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.