GPT and obesity due to melanocortin 4 receptor deficiency: For example, the urinary branched-chain amino acid (BCAA) valine associates positively to various obesity markers (e.g. BMI and waist-to-hip ratio, as well as body and visceral fat), clinical diabetes indicators and risk factors [glycated haemoglobin (HbA1c), fasting glucose, fasting insulin, and serum BCAAs valine, leucine and isoleucine), systemic inflammation (CRP and GlycA), serum triglycerides, blood pressure, liver function (ALP, ALT and GGT), and CKD as well as CVD risk (Figure 3).