Another mechanism is the initiation of endometrial cancer in obese patients which can be due to the disruption of Cx43 GJ intercellular communications by hypermethylation of the Cx43 promoter in normal endometrial epithelium mediated by the microenvironment conditioned by adipose stromal cells which massively release plasminogen activator inhibitor 1 [149]. Here, GJA1 is linked to endometrial cancer.