Not only that T2DM patients develop left ventricular hypertrophy because of hypervolemia that appears as a consequence of CKD, but also insulin resistance itself can trigger the expression of ectonucleotide pyrophosphatase phosphodiesterase 1 [ENPP1] gene, a gene known to be responsible of cardiac myocyte hypertrophy [20]. This evidence concerns the gene ENPP1 and left ventricular hypertrophy.