INS and obesity due to melanocortin 4 receptor deficiency: It has been reported that obesity, hypertriglyceridemia, and diabetes mellitus are associated with insulin resistance in adipocytes and hepatocytes, but hypertension is associated with insulin resistance in the vascular endothelium (35), which is why the prevalence of hypertension is not associated with AST/ALT but has to do with INS*PA (9).