INS and obesity due to melanocortin 4 receptor deficiency: Although leptin to adiponectin ratio (L/A) is a useful measure of insulin resistance both in diabetic and non-diabetic subjects [21,22,23,24,25] to predict the presence of the metabolic syndrome and cardiovascular risk [26,27], we also find the proinsulin to adiponectin ratio (P/A), the first component indicating β-cell and the later adipocyte cell dysfunction, a useful early indicator of T2DM associated with obesity.