SERPINE1 and obesity due to melanocortin 4 receptor deficiency: Obesity is considered a chronic inflammatory state characterized by continued infiltration of adipose tissue by macrophages and other immune cells leading to increased or decreased adipose secretion of adipokines [such as adiponectin, leptin, and plasminogen activator inhibitor-1 (PAI-1)] that may be linked to cancer development (104, 105).