However, higher zonulin levels showed a positive trend towards increased duodenal bacterial load (rs = 0.36, p = 0.061) and zonulin correlations also extended to obesity associated parameters such as body mass index (rs = 0.65, p = 0.01E−02), waist circumference (rs = 0.47, p = 0.009), and hip circumference (rs = 0.53, p = 0.003) (Supplementary Table 3). Here, HP is linked to obesity due to melanocortin 4 receptor deficiency.