These findings could be explained by the fact that obesity constitutes a hyper-inflammatory condition with increased levels of inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), elevated levels of cytokines such as tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and IL-8, and higher levels of adhesion molecules such as vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and P-selectin24–26. Here, VCAM1 is linked to obesity due to melanocortin 4 receptor deficiency.