In the presence of cardiometabolic risk factors (i.e., hypertension, obesity, prediabetes, and hypercholesterolemia) occurs endothelial cell activation, which is characterized by the expression of cell surfaces adhesion molecule, such as vascular cell adhesion protein 1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin. Here, VCAM1 is linked to obesity due to melanocortin 4 receptor deficiency.