The paracrine relationship between IMAT and skeletal muscle is of particular relevance to the dysregulation of glucose homeostasis and insulin resistance that is observed in metabolic disease, and while we have previously shown that IMAT conditioned media decreases insulin sensitivity in skeletal muscle cells in vitro (Sachs et al., 2019), little is known about the composition of the IMAT secretome. The gene discussed is INS; the disease is metabolic disease.