NOX4 and obesity due to melanocortin 4 receptor deficiency: Furthermore, De Hartigh et al. tested a high fat diet-load on adipocyte-specific NOX4-deficient mice, and found that NOX4-derived ROS in adipocytes is directly involved in the development of insulin resistance and adipose tissue inflammation, suggesting that NOX4-derived ROS is involved in obesity-related adipose tissue inflammation [31].