Downregulation of both genes correlated with effector T/NK cell lipid-mediated functional exhaustion and disrupted networks of immune checkpoints and chemokines, reflecting an immunosuppressive microenvironment.<h4>Conclusions</h4>ACAA1 and potentially ADI1 are downregulated candidate genes linking obesity to HCC. The gene discussed is ADI1; the disease is obesity due to melanocortin 4 receptor deficiency.