Previous researches have demonstrated that several molecules with possible autocrine or paracrine effects were produced by PVAT or epicardial adipose tissue in obesity, such as leptin, interleukin (IL)-6 and TNF-α, the expression of these molecules has been verified as independent risk factors in the pathogenesis of atherosclerosis [34, 35]. Here, LEP is linked to obesity due to melanocortin 4 receptor deficiency.