Consequently, several reports have demonstrated that insulin clearance is impaired in patients who are overweight or obese,83 similarly to patients with PCOS who are overweight or obese.84,85 Recently, our group evaluated the hepatic insulin extraction (HIE) index in patients with PCOS who are overweight or obese and found that this index indicated impairment, specifically when familial diabetes was present in at least one first-degree relative (parents and/or grandparents).84,85. The gene discussed is INS; the disease is polycystic ovary syndrome.