INS and endothelial dysfunction: Experimental evidence show that possible pathways may include endothelial dysfunction, overactivity of the sympathetic nervous system (Rajagopalan and Brook 2012), immune response alterations in visceral adipose tissues; endoplasmic reticulum stress resulting in alterations in insulin transduction (Sun et al. 2009), insulin sensitivity, and glucose metabolism; and alterations in mitochondria and brown adipocytes (Liu et al. 2013; Rajagopalan and Brook 2012).