INS and obesity due to melanocortin 4 receptor deficiency: An important role in male obesity-related Hypo-H has been attributed to hyperinsulinism, typically associated with obesity, particularly visceral obesity, as demonstrated by a cross-sectional cohort study on 178 men from a larger population-based study on diabetes and cardiovascular disease, in which TT and FT, but not SHBG, levels were negatively correlated with insulin levels, after adjustment for age, obesity, and body fat distribution (59).