IRS1 and Insulin resistance: This review discussed UA’s role in causing arterial stiffness and inflammation which is NLRP3 inflammasome dependent and is activated through AMPK-mTOR-mROS and HIF-1α. Cardiomyocytes with hyperuricemia exhibit insulin resistance due to the activation of the ROS-IRS1/Akt phosphorylation pathway and are positively correlated with the various components of MetS. Moreover, febuxostat effectively improves cardiovascular events as compared to allopurinol