It has been suggested that insulin resistance could induce the expression of cytokines which have tumour-promoting effects, elevated blood glucose is associated with increased vascular endothelial growth factor thus promoting angiogenesis and aiding tumour proliferation [128] and hyperinsulinaemia could increase the levels of bioavailable oestrogen through a reduction in sex hormone binding globulin (SHBG) levels. This evidence concerns the gene SHBG and neoplasm.