As an example, cut-offs for effective risk prediction based on NT-proBNP values by BMI and gender groups established in a multicenter study on a very large sample of patients with HF were as follows: for underweight patients with BMI < 18.5 kg/m2, NT-proBNP cut-offs were 3385 ng/L for females and 2953 ng/L for men; for normal weight patients (BMI 18.5–24.9 kg/m2), NT-proBNP cut-offs were 2728 ng/L for females and 2196 ng/L for men; for patients with class III obesity (BMI ≥ 40 kg/m2), NT-proBNP cut-offs were 889 ng/L for females and 631 ng/L for men [40]. Here, NPPB is linked to obesity due to melanocortin 4 receptor deficiency.