In MetS, the first signs of endothelial dysfunction have been observed in molecular alterations of hemostatic factors and fibrinolysis proteins, including plasminogen activator inhibitor-1 (PAI-1), low-density lipoprotein receptor-1 (LOX-1), and vasoconstrictor agent endothelin-1 (ET1), thereby causing vasoconstriction [58]. Here, EDN1 is linked to endothelial dysfunction.