CRP and obesity due to melanocortin 4 receptor deficiency: Adverse prognostic factors for worse outcome of RA have been shown to be female sex, positive rheumatoid factor (RF) or/and anti-citrullinated protein antibodies (ACPA or anti-CCP), HLA DR-4 shared epitope, early erosions, increased indices of inflammation (Erythrocyte Sedimentation Rate, ESR and C-Reactive Protein (CRP), polyarthritic involvement, deranged functional ability, smoking, obesity, low socioeconomic status and comorbidities.8