In human primary muscle cells incubated with conditioned media from IMAT, the IMAT expression of genes in insulin signaling including the JAKSTAT and MAPK signaling pathways, oxidative phosphorylation, inflammatory cytokine gene expression (e.g., plasminogen activator inhibitor 1, monocyte chemotactic protein 1, TNF alpha-induced protein 3 among others), and peroxisomal metabolism related to insulin sensitivity of the donor indicating that numerous factors secreted from IMAT may regulate insulin resistance [27]. Here, SERPINE1 is linked to Insulin resistance.