In addition, a survey of non-obese individuals in Japan has revealed that insulin resistance in skeletal muscle increases when the risk of heart disease, such as hypertension and dyslipidemia, is also present [109], and non-obese Japanese men with a fatty liver alone had a lower insulin sensitivity than those with visceral fat accumulation alone, suggesting that insulin resistance may develop without fat accumulation in adipose tissue [110]. The gene discussed is INS; the disease is Insulin resistance.