INS and obesity due to melanocortin 4 receptor deficiency: IR induces hyperinsulinemia that could lead to the rise in reabsorption of renal urate through the stimulation of urate-anion exchange; thus, there is a reduction in the excretion of uric acid from the renal tubular cells due to insulin, increasing uric acid impacts pro-inflammatory action on adipocytes as well as stimulates cell proliferation, and the impairments in sensitivity to insulin and effectiveness of glucose of cells because of the impact to glucose indicate transport that is integral in obesity, and MetS (32, 33).