Several potential mechanisms can be taken into account to explain the association between T2DM and TC including the higher prevalence of abnormal serum TSH levels (236), the effects of elevated insulin and/or glucose levels in affecting cellular energy metabolism [by increasing the intracellular adenosine triphosphate (ATP)/adenosine monophosphate ratio and inactivating AMPK] (237) and immune system (by increasing ROS production and especially nitric oxide) (237, 238) (Figure 1). The gene discussed is INS; the disease is type 2 diabetes mellitus.