In addition, they were more likely to have fasting hypertriglyceridemia, low HDL cholesterol, elevated insulin, impaired glucose metabolism, acanthosis nigricans, and T2D, whereas there was no significant difference in the prevalence of obesity or severe obesity, hypertension or other lipid parameters (Figure 3; Supplementary Table). Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.