In subjects with obesity at initial assessment, there was a significant increase in adiponectin (p < 0.05), sclerostin (p < 0.01) and TNF-α (p < 0.05) concentrations, and a significant decrease in osteopontin (p < 0.01), NGAL (p < 0.01) and leptin (p < 0.01) concentrations compared with annual assessment. The gene discussed is SOST; the disease is obesity due to melanocortin 4 receptor deficiency.