However, several common contributing factors have been identified [31], including patient non-compliance [32], genetic polymorphisms (e.g., COX-1 variants) [33], hyper-reactivity of platelets [34], drug interactions [31], as well as conditions such as obesity [35] and diabetes [36], which may alter aspirin’s efficacy. The gene discussed is PTGS1; the disease is obesity due to melanocortin 4 receptor deficiency.