There is a large body of evidence regarding the fact that elevated levels of some SPARC proteins, such as osteonectin and osteopontin, have demonstrated a strong association with poor long-term HF-related outcomes including death, and a risk for recurrent hospitalization due to HF among patients with normal body mass, overweight, and obesity [201, 202]. Here, SPARC is linked to obesity due to melanocortin 4 receptor deficiency.