INS and obesity due to melanocortin 4 receptor deficiency: In a multi-ethnic cohort of children with obesity, a genetic risk score (GRS) of five gene variants in the genes TCF7L2, IGF2BP2, CDKAL1, HHEX, and HNF1A, all known to modulate insulin secretion, was associated with lower insulin secretion and increased risk of progressing from normal glucose tolerance to IGT or diabetes [43].