INS and metabolic syndrome: Similarly, higher levels of circulating insulin is also associated with low HDL levels.9 As one of the manifestations of insulin resistance is a higher HbA1c therefore, it may be a common factor in the present study, although insulin is not measured in our study to confirm the hypothesis but the BMI and presence of metabolic syndrome supports our hypothesis of insulin resistance associated increasing HbA1c, these factors can result as a consequence in dyslipidemia as already discussed.