VCAM1 and hyperinsulinism: Hyperinsulinemia may reflect an altered level of insulin sensitivity and be associated with chronic inflammation, characterized by high levels of IL-6, C-reactive protein, tumor necrosis factor-α, fibrinogen, and the cell adhesion molecules ICAM-1 and VCAM-1.150 Moreover, hyperinsulinemia induces proliferative tissue abnormalities due to strong anabolic effects, resulting in the enhancement of DNA synthesis and cell proliferation.