The mRNA expression levels of ER stress markers (Xbp1, sXbp1, Atf4, Atf6, and Grp78) were significantly higher in the ASCs treated with hypertrophic obesity adipocyte-derived EVs than in the ASCs treated with control adipocyte-derived EVs (Figure 4(d)). The gene discussed is ATF6; the disease is obesity due to melanocortin 4 receptor deficiency.