While increases in the PPARɣ axis have been associated with improved insulin sensitivity, the fact that neither PPARG nor PPARGC1A correlated with HOMA-IR suggest that in severe obesity, the observed increases are instead, likely a reflection of greater adipogenesis where AGER has also been implicated and may explain the strong correlation between these genes. Here, PPARGC1A is linked to obesity due to melanocortin 4 receptor deficiency.