Animal models suggest that the hepatic parasympathetic nerve dysfunction causes the development of skeletal muscle insulin resistance, linking with the actions of hepatic insulin sensitizing substance (HISS) released from the liver and of the glucose uptake in the skeletal muscle.32 The hepatic parasympathetic nerves regulate the HISS function; therefore, the impairment potentially lowers peripheral insulin sensitivity, which is consistent with our findings. The gene discussed is INS; the disease is Insulin resistance.