Therefore, an excessive dietary intake of phosphate induces the secretion of PTH and FGF23.(17,18) Several studies have suggested that elevated PTH levels may be a risk factor for metabolic syndrome.(19,20) In adipocytes, PTH induced insulin resistance and fatty acid release.(21) FGF23 also affected obesity in people with normal kidney function.(22). This evidence concerns the gene FGF23 and obesity due to melanocortin 4 receptor deficiency.