SERPINH1 and obesity due to melanocortin 4 receptor deficiency: Based on the expression patterns of HSP47–upregulation in feeding, overeating, and obesity, while downregulation in fasting, exercise, calorie restriction, bariatric surgery, and cachexia–we hypothesized that endocrine hormones, such as insulin and glucocorticoids may be involved in regulating HSP47 expression.