INS and obesity due to melanocortin 4 receptor deficiency: It is unclear why there is no correlation between WC, triglycerides, total cholesterol, LDL-C, or HOMA-IR with AN severity degree in neck by Burke's scale grade 4 in our study, though it may be due to increased leptin concentrations that play a compensatory role in patients with insulin intolerance or resistance due to more severe obesity.