Abnormal levels of these factors have been shown to be strongly associated with both insulin resistance (IR) and type 2 diabetes mellitus (T2DM) and in patients with the PCOS, a severe dysfunction of adipose tissue has been observed leading to over-production of pro-inflammatory adipokines such as TNFα and, concurrently, reduction of a few “beneficial adipokines” such as APN. This evidence concerns the gene ANPEP and polycystic ovary syndrome.