INS and obesity due to melanocortin 4 receptor deficiency: It has been hypothesized that the higher death rate observed in obese hypertensive individuals compared to obese alone individuals may be the result of a combination of several overlapping factors, including the regulation of appetite and satiety, endothelial function, energy expenditure, haemostasis, insulin sensitivity, blood pressure, adipogenesis, fat distribution, and insulin secretion in pancreatic β-cells, all of which have been attributed to obesity and hypertension (Re, 2009).