In this sense, a low Adpn/Lep ratio indicates a dysfunctional adipose tissue that may be accompanied by alterations in metabolism in the case of well-established obesity or may be suggesting a dysfunctional adipose tissue in the first stages of obesity or pre-obesity that, with time, will likely lead to the development of metabolic abnormalities. Here, LEP is linked to obesity due to melanocortin 4 receptor deficiency.