Visceral adipose tissue accumulation also promotes an increase in the secretion of angiopoietin-like protein 2 (Angptl2), a pro-inflammatory factor derived from adipocytes and considered a key mediator of chronic adipose tissue inflammation and obesity-related systemic insulin resistance (Tabata et al., 2009). This evidence concerns the gene ANGPTL2 and obesity due to melanocortin 4 receptor deficiency.