At the age of 10–15 years, hyperinsulinemia appeared milder in the group with LEP deficiency as compared with the patients with LEPR and MC4R deficiencies (mean 49 versus 104 and 66 μIU/mL in children with LEP, LEPR, or MC4R deficiency, respectively) (range of insulin assay: 0–300 μIU/mL) (Table S5A). Here, MC4R is linked to hyperinsulinemic hypoglycemia, familial, 4.