LEP and serum lipopolysaccharide activity: Despite the prevalence of obesity-induced inflammation, the pathogenesis of this condition is still uncertain but is possibly a combination of several mechanisms including (i) immune responses toward adipocyte injury from hypertrophic adipocyte hypoxia and adipocyte apoptosis3,4, (ii) reduction of adiponectin together with leptin elevation, (iii) metabolic dysregulation and mitochondria dysfunction and (iv) gut permeability defect (gut-leakage) induced endotoxemia (metabolic endotoxemia)5.