PPP2R2D and obesity due to melanocortin 4 receptor deficiency: A recent systematic review identified age, obesity, and hypertension as potential risk factors for the development of this condition.[14] At the molecular level, esophageal cervical spondylosis appears to be linked to genetic, metabolic, and vascular factors.[13] Several studies have identified genes associated with the condition, such as FGF2, COL6A1, PPP2R2D, and BMP4.