LEP and obesity due to melanocortin 4 receptor deficiency: These ‘adipokines’ are essential in the regulation of food intake and energy homeostasis with leptin being implicated in various obesity-related cardiovascular diseases, whereas adiponectin is considered cardioprotective.55 Epicardial fat deposition due to altered adiponectin and leptin regulation is one of the theories implicated in the development of heart failure.56 Increased serum leptin concentrations are seen in patients with heart failure and they are associated with cardiac remodelling due to cardiac fibrosis and inflammation.57