In addition to adipose tissue all nucleated human cells have the capacity to respond to endotoxin as part of their innate immune response where the myeloid differentiation factor 2/toll-like receptor 4 (MD2-TLR4) can sense circulating endotoxin and initiate a local or systemic inflammatory processes involved in pathologies as diverse as metabolic syndrome, atherosclerosis, obesity, and T2DM (Shimazu et al., 1999, Andreasen et al., 2008). Here, TLR4 is linked to type 2 diabetes mellitus.