Leptin was also elevated in these subjects with overweight/obesity; although no reference values have been internationally established, the concentrations obtained here were above the cut-off values for cardiometabolic abnormalities reported in a Spanish sample of 11,000 subjects, i.e, 6.45 ng/mL for males and 23.75 ng/mL for females (Gijón-Conde et al., 2015). Here, LEP is linked to obesity due to melanocortin 4 receptor deficiency.