LEP and obesity due to melanocortin 4 receptor deficiency: Obesity-related chronic inflammatory phenotype is characterized by release of an array of proinflammatory mediators including cytokines (e.g., interleukin-6 (IL-6), interleukin 1β, tumour necrosis factor-α (TNF-α)), and adipokines (e.g., leptins) [118], which promote insulin resistance through alterations in the extracellular matrix, capillary network architecture, and glucose uptake mechanisms.