INS and atherosclerosis: In typical circumstances, the presence of insulin at physiological levels induces vasodilation and enhances vascular recovery through the augmentation of nitric oxide (NO) synthesis by endothelial cells (ECs) [17, 18], However, in the context of insulin resistance (IR), these beneficial effects of insulin may be diminished, and in fact, insulin may elicit vasoconstriction by promoting the production of vasoconstrictive agents such as endothelin and/or contributing to the development of pathological atherosclerosis.