INS and obesity due to melanocortin 4 receptor deficiency: Obesity is considered to be the core figure contributing to the increased morbidity and mortality resulting from metabolic syndrome, and these are attributed to various factors including ineffective activities of the renin-angiotensin system, elevated proinflammatory cytokines activities, vasoconstriction from increased activities of sympathetic nervous system, deregulation of adipokines synthesis and secretion, alteration in the level of circulating insulin, and bioavailability of insulin-like growth factor-1 (IGF-1) [6].