Additionally, owing to the close association between metabolic syndrome (MetS) and obesity and the fact that N-terminal B-type natriuretic peptide (NT-proBNP), a key diagnostic marker for heart failure, has decreased diagnostic sensitivity in patients with obesity (7, 8), the diagnostic value of NT-proBNP for HEpEF is further constrained. The gene discussed is NPPB; the disease is obesity due to melanocortin 4 receptor deficiency.