ADIPOQ and obesity due to melanocortin 4 receptor deficiency: The impaired productionof adiponectin by adipocytes in obesity is the result of oxidative andendoplasmic reticulum stress and the activation of inflammatory cytokines thatare prevalent in the adipose tissue of the obese individuals.62 Therefore, the reduction in adiponectin in obesity may be influential inthe development of PAH by impeding its ability to modulate vascular tone,regulate inflammatory responses and attenuate vascular smooth muscle cellgrowth