However, detailed Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of differentially expressed genes (DEGs) in visceral fat suggested that the upregulated DEGs were enriched in inflammatory pathways, including ‘primary immunodeficiency’, ‘NF-kappa B signaling’ and ‘T cell receptor signaling pathway’, whereas downregulated DEGs were significantly enriched in pathways related to metabolism, including ‘oxidative phosphorylation’, ‘thermogenesis’, ‘PPAR signaling’ and ‘insulin signaling’ pathways (Supplementary Fig. 1c). Here, INS is linked to inborn error of immunity.