INS and obesity due to melanocortin 4 receptor deficiency: As the four components of the MetS, (1) waist circumference to assess obesity, (2) systolic (SBP) and diastolic blood pressure (DBP) to assess hypertension, (3) triglycerides or high-density lipoprotein cholesterol (HDL-C) to assess dyslipidemia and (4) HOMA-insulin resistance or fasting blood glucose to assess insulin sensitivity are recommended.