These potential links may involve the interactions with shared risk factors (e.g., obesity, hyperglycemia, hyperinsulinemia, insulin resistance, high salt intake, smoking, etc.), HP infection, medications (e.g., insulin, metformin, aspirin, statins, proton pump inhibitors, antibiotics, etc.)and comorbidities (e.g., hypertension, dyslipidemia, vascular complications, heart failure, renal failure, etc.)[16]. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.