INS and obesity due to melanocortin 4 receptor deficiency: Our study compared the blood lipid, insulin levels, and BMI of the TS between the normal hearing group and the hearing loss group, and found that TS with HL was not associated with insulin resistance, obesity, and dyslipidemia, may be related to lifestyle or drug treatment interventions, such as metformin, metabolic abnormalities, and further studies are needed to explain the potential pathological mechanism between metabolic abnormalities and SNHL.