Another study of severely obese adolescents enrolled at a National Obesity Center in Sweden examined the relationship between insulin-glucose metabolism, nocturnal blood pressure dipping and cardiac left ventricular mass and found that non-dipping was common and negatively associated with measures of insulin metabolism including Homeostatic Model Assessment of Insulin Resistance (HOMA) index and fasting insulin (27). This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.