LEP and obesity due to melanocortin 4 receptor deficiency: Leptin, in turn, is an endocrine hormone derived from fat cells with paradoxical effects (12); despite its fundamental protective role in the cardiovascular system, there are detrimental mechanisms in obesity models whereby leptin is associated with elevated oxidative stress and decreased nitric oxide bioavailability in endothelial cells, facilitating thrombosis formation and atherosclerosis via hypertrophy, proliferation, migration, and calcification of vascular smooth muscle cells (13).