E2F1 and obesity due to melanocortin 4 receptor deficiency: All participants were with extreme obesity (BMI > 45 kg/m2), older than patients in Cohort 1, and, remarkably, all those with low VAT-E2F1 were without T2DM and all those with high VAT-E2F1 were with T2DM, reflecting the metabolic impact associated with high-VAT-E2F1 expression [12] (Table 2).