In several studies it has been observed that ENPP1, which is connected directly to the insulin receptor α, impairs receptor function and then reduces the signaling cascade, in a wide variety of tissues such as skeletal muscle and liver.23 In some other studies has been observed that the expression level of ENPP1 in patients with insulin resistance has been increased and also it is mentioned that regulatory increased ENPP1level in rat liver, induces insulin resistance and glucose tolerance.24-26. Here, INSR is linked to Insulin resistance.