GDF15 and obesity due to melanocortin 4 receptor deficiency: Unadjusted (P<sup>1</sup>) and age-adjusted (P<sup>2</sup>) P-values were reported.<h4>Results</h4>Among 88 frail women (72.7% pre-frail and 27.3% frail), obesity plus LALM showed lower IGFBP-3 and higher GDF-15 vs. LALM (P<sup>2</sup> = 0.041 and P<sup>2</sup> = 0.032); obesity had higher resistin vs. LALM (P<sup>2</sup> = 0.012), replicated in sensitivity analysis frail-only (P<sup>2</sup> = 0.002), elevated insulin (P<sup>2</sup> = 0.002) and a trend slower chair stand (P<sup>2</sup> = 0.055).