Second, the adipose tissue of obese individuals produces large amounts of bioactive mediators that lead to insulin resistance, which in turn affects apolipoprotein A1 (apoA-I) production or hepatic high-density lipoprotein (HDL) secretion and finally induces the development of metabolic syndrome26, and insulin resistance also impedes normal cardiac function by inhibiting metabolic pathways and overstimulating growth factors27. This evidence concerns the gene APOA1 and Insulin resistance.