INS and Insulin resistance: The association between lipodystrophy and HAART exists because protease inhibitors impair adipocyte differentiation through mechanisms that include the inhibition of proteins that are part of lipid metabolism and insulin dysregulation, resulting in adipose hypertrophy (especially in the viscera), decreased high-density lipoprotein (HDL), increased triglycerides, insulin resistance, type 2 diabetes mellitus, and hypertension (18).