In addition, in the early stages of atherosclerosis, insulin resistance may also lead to an increase in atherosclerotic plaques through the downregulation of the insulin receptor-Akt1 signalling pathway, causing, among other things, a decrease in the activation of eNOS in arterial endothelial cells and an increase in the expression of VCAM-1 [44]. The gene discussed is VCAM1; the disease is atherosclerosis.