INS and Insulin resistance: The observed impairments in adipose tissue function could be associated with insulin resistance by at least the following mechanisms: (1) Inflammation in fat and a direct action of cytokines or other mediators on the insulin signaling cascade [42], (2) decline in mitochondrial DNA content or function [43], and (3) diminished adipocyte differentiation within subcutaneous adipose tissue and subsequent increase in ectopic fat deposition [11,12].