Moreover, our data about visfatin-increased TYMS expression level through p38 signaling and Sp1 transcription factor further proposed a possible role and mechanism of obesity in CRC patients to initiate the resistance of 5-FU-included chemotherapy through regulating the TYMS expression level, and this should be considered in the future therapeutic strategy. Here, NAMPT is linked to obesity due to melanocortin 4 receptor deficiency.