INS and obesity due to melanocortin 4 receptor deficiency: This process promotes ceramide synthesis, whichtriggers β-cell apoptosis by releasing cytochrome c from the mitochondria and activating the apoptotic cascade., Thus, lipotoxicity may drive ceramide overproduction, disrupt theliver, kidneys, and muscles function, and lead to endoplasmic reticulum(ER) stressall key events contributing to insulin resistanceand cell death, involved in obesity progression. Finally, a shift in the abundance of sphingolipids canlead to an increase in the caloric uptake through satiety-signalingand a disturbance of fat storage and adipokine secretion.