Our study and many other studies have found that a higher level of total cholesterol is a significant predictor of the presence of hypertension in adult patients with TNs [10,16,31,34,46], indicating the positive and significant association of the components of metabolic syndrome and the formation of TNs associated with insulin resistance, insulin-like growth factor-1 and high level of inflammatory markers [10,11,46]. Here, IGF1 is linked to Hypertension.