IGF1 and Insulin resistance: The elderly male patients may already be more vulnerable to the development and consequences of insulin resistance owing to the lower circulating levels of adiponectin [77] and the higher bioavailability of the insulin-like growth factor-1 [78], which is mainly produced by the liver as an insulin-mimetic hormone, particularly under insulin resistance [79,80], and considered to be the major chemoattractant for the liver metastases of UM [81,82].