INS and liver dysplastic nodule: Visfatin, or pre-B cell colony-enhancing factor, is synthesized in adipocytes, had an important paracrine role in the development of DN through inducing tyrosine phosphorylation of the insulin receptor, activating downstream insulin signaling pathways and increasing the levels of TGF beta1, PAI-1, type I collagen, and MCP-1 (CCL2) [33].