Participants in the highest TyG index quartile showed statistically increased risk of VDD when compared with those in the lowest TyG index quartile after adjustments for age, sex, smoking, obesity, insulin therapy, hypoglycemic agents’ medication [OR 2.44; 95% CI 1.45–4.10; P < 0.001]. The gene discussed is INS; the disease is obesity due to melanocortin 4 receptor deficiency.