INS and obesity due to melanocortin 4 receptor deficiency: Obesity-induced adipocyte hypertrophy is associated with reduced insulin sensitivity, increased oxidative stress, and abnormal adipokine secretory profile, including an elevated array of other pro-inflammatory factors [IL-1β, IL-8, resistin and monocyte chemoattractant protein 1 (MCP1)] and a reduced array of anti-inflammatory factors (IL-10, adiponectin and FGF21) [131,132].