ICAM1 and Insulin resistance: Visceral fat accumulation induces a pro-inflammatory state, resulting in endothelial activation (PAI-1, ICAM-1, VCAM-1, endothelin-1) which allows for circulating immune cells diapedesis (passage from the blood to the tissues) where arrival perpetuates the pro-inflammatory state and produces insulin resistance (Meigs et al., 2004).