HMOX1 and metabolic syndrome: Additionally, IRS-1 (p < 0.05), p-Ser473 AKT (p < 0.01), SIRT1 level (p < 0.01) and activity (p < 0.001), Nrf2 level (p < 0.01) and activity (p < 0.01), and HO-1 (p < 0.01) are significantly increased in the MetS/E group compared to the MetS group.