Hypoxia promotes aggressive malignancy and is associated with poor prognosis in a wide range of cancer types.15–17 Oxygen deprivation results in the expression of hypoxia-inducible factors (HIFs), which mediate multiple protective mechanisms that help in maintaining oxygen homoeostasis by reducing oxidative metabolism and oxygen consumption.18–21 One such inducible factor, HIF-1α, is a key regulator of multiple cancer-related metabolic pathways, including glycolysis, glycogenesis, the TCA cycle, nucleotide metabolism, amino acid metabolism, leptin metabolism, lipid metabolism and others.22–25. The gene discussed is LEP; the disease is cancer.