It is worth noting that the expression of transforming growth factor-β (TGF-β), tumour necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) is upregulated in adipocytes of obese individuals and those with diabetes [32], providing a mechanism for increased PAI-1 levels in obesity and insulin resistant states. Here, SERPINE1 is linked to obesity due to melanocortin 4 receptor deficiency.