Figure 2 summarizes several potential factors involved in hyperinsulinemia and insulin resistance. Excess calorie intake may induce increased pancreatic insulin secretion and/or reduced hepatic insulin clearance. Both increased pancreatic insulin secretion as well as reduced hepatic insulin clearance have been suggested to be etiological factors in the development of hyperinsulinemia and insulin resistance (see also legends in Figure 2 and previous paragraphs for more details). Here, INS is linked to Hyperinsulinemia.