INS and metabolic syndrome: Adiponectin has been shown to increase insulin sensitivity in skeletal muscles and liver tissue .(36) Adiponectin increases peroxisome proliferator-activated receptor-a (PPAR-a) ligand activity and stimulates fatty acid oxidation and glucose uptake(37) Sitagliptin improves adipose tissue inflammation, metabolic syndrome, and fatty liver by regulating adiponectin and AMPK levels in obese rats, also, increased GLP-1 levels cause insulin-independent effects on adipose tissue and liver (36).