We showed that GrB in VAT associated with markers of apoptosis, as caspase 3 and caspase 7, and, since inflamed VAT in obesity undergoes increased caspase-mediated apoptosis of adipocytes (41, 42), GrB in VAT might be indicative of a possible direct role of this serine protease in promoting adipocyte apoptosis. This evidence concerns the gene GZMB and obesity due to melanocortin 4 receptor deficiency.