Randrianarisoa et al. (2018) showed a correlation between brachial artery PVAT and insulin resistance, while aorta PVAT is associated with carotid IMT, indicating that brachial artery PVAT and aorta PVAT may act differently as possible modulators of insulin resistance and subclinical atherosclerosis. However, Alkhalil et al. (2018) demonstrated the dissociation between the spatial distribution of PVAT and arterial wall thickening in the aorta and carotid arteries, which does not support that PVAT promotes atherosclerotic plaque through the paracrine route. Here, INS is linked to atherosclerosis.