Under the stimulation of insulin, pancreatic fat consistently secretes inflammatory factors such as IL-6, TNF to alter chronic inflammation in the pancreas, which finally leads to oncogenic mutation and the onset of PDA (Klöting and Blüher, 2014; Murphy et al., 2018; Brocco et al., 2020; Luo et al., 2021). Here, INS is linked to Patent ductus arteriosus.