Although some other physiological factors may cause discrepant NT-proBNP measurements—for example, a consistent inverse relationship between obesity (BMI ≥ 30) and circulating natriuretic peptide levels has been demonstrated [3]—NT-proBNP remains a core biomarker that serves multiple functions in the management of HF. Here, NPPB is linked to obesity due to melanocortin 4 receptor deficiency.