It has been known for some time that insulin insensitivity can cause a distinct biochemical syndrome with elevated free fatty acids [77] and in metabolic syndrome-prone subjects, relative tissue hypoinsulinemia results in release of excess free fatty acids, mainly from visceral depots, resulting in increased liver synthesis VLDL, elevated triglycerides, increased HDL clearance and small dense LDL. The gene discussed is INS; the disease is metabolic syndrome.