Cluster 2 (denoted as hypermetabolic obesity hyperuricemia subtype [HMO-U]) and cluster 3 (denoted as hypermetabolic obesity hyperinsulinemia subtype [HMO-I]): included 289 (33%) and 71 (8%) patients, respectively, both characterized by slightly increased glucose, compensated insulin secretion, and increased UA. The gene discussed is INS; the disease is obesity due to melanocortin 4 receptor deficiency.