The reduction in the Framingham HARD CHD risk score by 29% is similar to that previously described in patients with plain obesity [23] and occurred in parallel to a simultaneous diminution in the use of insulin by 35% and of OADs other than metformin and DPP-4 inhibitors up to 99%. The gene discussed is DPP4; the disease is obesity due to melanocortin 4 receptor deficiency.