INS and obesity due to melanocortin 4 receptor deficiency: Advances in the knowledge of adipose tissue biology have shed light on the mechanisms by which obesity and abnormal body fat distribution promotes atherosclerosis, dysglycemia, dyslipidemia and hypertension, including the ability of adipose tissue to modulate ectopic lipid accumulation in insulin responsive tissues [35], the secretion of protein and lipid endocrine mediators (adipokines) [36] and the modulation of tissue specific and general inflammatory status [37].