INS and Insulin resistance: The differences in the fat distribution between the 2 groups could potentially explain the insulin resistance seen in the IHH FGFR1m participants, as abdominal obesity is often linked to ectopic fat deposition (eg, in muscle and liver) and may underlie the resistance to the effects of insulin on peripheral glucose and fatty acid utilization observed in patients with low insulin sensitivity, prediabetes, and diabetes [22, 28, 29].