PNPLA3 and obesity due to melanocortin 4 receptor deficiency: Notably, PNPLA3 GG carriers with diabetes and obesity had significantly lower VLDL-1 lipids even in the fasted state compared with CC carriers (Fig. 4D), highlighting the impact of the PNPLA3 rs738409 (p.I148M) variant in these patients at high metabolic risk.