Additional proposed cancer-promoting factors, especially in the conjunction with concomitant obesity, are hyperglycemia, hyperlipidemia as well as increasing circulating levels of leptin, estrogen, resistin, and inflammatory cytokines along with reduced concentrations of IGF binding proteins and adiponectin levels [190] which are proposed to play a permissive role in tumor cell proliferation, dissemination, and oncogene expression [191]. This evidence concerns the gene LEP and obesity due to melanocortin 4 receptor deficiency.