However, no association was found between the adverse outcome and obesity, as has been found in other studies 20,22 where the outcome was mortality and, like DM, obesity involves a proinflammatory state due to cytokines (TNF-alpha, MCP-1 and IL-6) produced by adipose tissue .12 The gene discussed is CCL2; the disease is obesity due to melanocortin 4 receptor deficiency.